Reimbursement

In 2014, under the Medicaid Expansion provision of the Patient Protection and Affordable Care Act (PPACA) approximately 20 million uninsured Americans will qualify for coverage under the state-run program. The devil is in the details.

Acquiring and retaining the best risk, meeting the 80 percent medical loss ratio and establishing cost-effective distribution channels and working with exchanges are top priorities of executives of health insurance companies, according to a recent survey.

A New York has granted final approval to a $350 million settlement between the American Medical Association and the UnitedHealth Group, giving doctors just one day file claims to share in the fund.

Alisa Ray, executive director of the Certification Commission for Health Information Technology, said Friday that CCHIT doesn't foresee a backlog of any kind in accommodating testing for meaningful use certification.

California's critical-access, rural hospitals got a big boost when UnitedHealth Group announced it would provide $10 million in loans to help them adopt electronic health records and improve their health IT systems, and $1 million in grants to jumpstart the process.

One of the most significant - and hotly debated - parts of the new health care reform law is scheduled to come into effect on the first day of 2011. It's one that's likely to impact insurers, employers, and individual consumers.

Health Language, Inc. (HLI), a maker of medical terminology management software, and HCL Technologies, a global IT services provider based in India, have joined forces to put HLI's Language Engine to work as part of HCL's end-to-end ICD-10 conversion solution.

Questionable medical claims referred to the National Insurance Crime Bureau totaled 28,553 in 2009, a 10 percent increase over 2008's 25,945 claims.

Some of the first significant elements of the Patient Protection and Affordable Care Act (PPACA) go into effect today, and a number of articles provide details of the changes.

A-Life Medical, the San Diego-based computer-assisted coding company, is the newest firm to be brought into the Ingenix fold. The acquisition follows a strategic alliance formed between the two companies last year. Terms of the deal were not disclosed.