Context: access and costs
OECD’s Health at a Glance 2025 identifies unmet healthcare needs in Poland. Cost review should therefore consider both unnecessary services and necessary care, rather than automatically seek lower expenditure.
What can be reviewed?
Do the records support the scope and frequency of services? Did repeated tests address a new clinical question? Is the duration of hospitalisation, rehabilitation or a procedure explained? Medical indications and contractual billing compliance are different questions.
An INEM assignment
After case assessment, we select a physician for the specialty and questions. An agreed report may relate services to the records, explain the medical assessment and identify items requiring clarification. Savings are not predetermined; the findings may also support the costs incurred.
What should your enquiry include?
The purpose, recipient, specialty, type of costs and deadline. Bills and medical records follow through the agreed channel. Medical, legal and accounting assessments are distinguished in the scope.