Reimbursement
The Department of Health and Human Services on Monday proposed new rules to help fight waste, fraud and abuse in Medicare, Medicaid and the Children's Health Insurance Program.
The Association of Northern California Oncologists (ANCO) recently selected Via Oncology Pathways as a preferred pathways option for its nearly 400 members.
In the wake of healthcare reform, provider-owned health plans are under financial pressure, but a new study indicates providers are still interested in creating or acquiring health plans.
Prematics and Navinet have joined forces, with Navinet's real-time healthcare communications network enabling delivery of the Prematics care communication solutions to mobile devices – offering docs access to administrative, clinical and fina
The healthcare industry is undergoing a transformation of historic proportions. Our task is to reduce healthcare costs and improve the quality of care. The industry is not short on ideas aimed at accomplishing this feat, but determining which initiatives will prove effective is a challenge.
Blue Cross Blue Shield of Massachusetts is implementing an interesting method to highlight out-of-network costs and to reduce them.
A company offering Web-based billing management software for small physician practices is looking to boost business with a new infusion of cash.
CarePayment Technologies, Inc., a Portland, Ore.-based provider of financial and patient advocacy services for healthcare providers, has acquired San Francisco-based Vitality Financial, which provides hospital payment solutions to medical providers and patients.
If anyone doubted that (a) insurers would fight back against the coverage requirements of PPACA or (b) that those being regulated will always have the advantage over the regulators, or (c) there's no free lunch, these items should rapidly dispel the illusion.
Now that we know the RACs are rolling out their reviews of claims related to medical necessity (Regions B, C and D), it is worthwhile to consider once again how individual providers will plan and react to this challenge.