Reimbursement
The 120 network hospitals and 30-plus physician groups participating in Blue Shield of California's (BSC) claims transparency program continue to reap shorter claims cycle times and fewer denials, resulting in significant savings.
The Institute for Clinical Systems Improvement, a nonprofit organization comprised of 60 medical groups and six health plans in Minnesota and surrounding states, will use decision support technology to help ensure patients only receive medically appropriate diagnostic imaging tests.
Nuance Communications announced Wednesday that the Institute for Clinical Systems Improvement (ICSI), a nonprofit organization made up of 60 medical groups and six health plans throughout Minnesota and surrounding states, has licensed its RadPort decision support technology to help ensure patients only receive medically appropriate diagnostic imaging tests.
Variations in insurance markets from state to state mean there is no single formula for how to set up the new health insurance exchanges, as required under healthcare reform.
A new poll conducted by the American Medical Association indicates 94 percent of Americans are concerned about a looming 25 percent cut in Medicare reimbursements to doctors.
Robust healthcare IT systems able to specifically classify treatments based on an individual patient's profile are vital for payers in order to properly manage value-based benefits according to Mark Fendrick, co-director of the Center for Value-Based Insurance Design, and other industry experts - representing health plans, government and service providers - all speaking Monday at the AHIP Fall Forum.
In an effort to reduce the number of improper payments under state Medicaid plans, the Centers for Medicare & Medicaid Services has proposed new rules for Medicaid's Recovery Audit Contractor program.
An analysis by the Department of Health and Human Services estimates that under the Affordable Care Act, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next 10 years.
A new study shows that 98 percent of kidney care providers will participate in the new Medicare bundled payment system next January.
The U.S. Department of Veterans Affairs (VA) has awarded QuadraMed a five-year, $211 million contract to implement its Quantim coding, compliance and abstracting solution.