Claims Processing
AHA has “substantial concerns” over the vendor payment structure in WISEeR that incentivizes denials at the expense of physician judgment.
Providers know instantly what’s covered, payers receive more comprehensive claims and patients know their coverage before leaving the doctor's office, Optum says.
The main reason for the increase is the expected end of the premium tax credits.
Underpayment is one of the most damaging issues financially for hospitals reporting that over a year, 32% of claims were underpaid, representing $5B in lost revenue, says John Yount, Chief Innovation Officer, FinThrive.
Baptist Health Chief Revenue Officer says the health system will often eat the cost of a service rather than delay care.
Patient self-pay is increasing, says Curae Finance, which announced the new partnerships.
Managing the cost of GLP-1 drugs for weight loss is the top priority in pharmacy benefits, says Mercer survey.
Abridge technology will be deployed across Allegheny Health Network’s 14 hospitals and the Highmark insurance division.
Reasons include the expected end of tax credits, increasing costs and utilization and, potentially, tariffs.
An Advanced Explanation of Benefits for upfront estimates remains an outstanding provision of the No Surprises Act, senators say.