Healthcare Finance Staff

A national for-profit giant and Michigan's largest health insurer are coming to a resolution over the long-standing, fractious trade issues of excluding and favoring.

A mix of old and new school insurers are the best health plans in the eyes of the 59,000 physicians and providers using the digital billing and record-keeping services of athenahealth.

Jay LaBine, MD, is a surgeon working at the forefront of America's changing healthcare economy, the provider-sponsored health plan.

As dry as the decision may appear, insurers literally have millions of dollars on the line when CMS comes knocking. That makes picking the right auditor, and doing so the first time, absolutely critical.

The chief lobbyist for American health insurance is taking a job at a regional nonprofit insurer, after shaping a once-in-a-generation reform aimed at benefiting both the public and the industry.

It was only a matter of time until a big regional Blue Cross insurer got hacked, except that time was a year ago and security experts just recently uncovered it.

Aetna has found itself in the odd position of being fined for covering something some members wanted, while not being fully up to speed covering another condition.

The trajectory of cancer care is so costly and problematic that insurers are flocking in droves to the federal government's multi-payer alignment experiment.

With little more than a year of claims experience on the new individual market, some insurers are looking for premium increases of more 30 percent, including the Blues. Though affordability is still relative.

The challenge that health plans face is that within the spectrum of fraud, waste and abuse, it can be unclear if a billing mistake is accidental or intentional.