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Claims Processing

By Susan Morse | 09:54 am | October 13, 2020
Affordable Care Act medical loss ratio rebates in 2021 will likely be exceptionally large across commercial markets. 
03:52 pm | September 30, 2020
Communication between consumers and payers needs to be seamless, and all need to have access to the same health plan information, Zipari CEO says.
10:45 am | September 18, 2020
The American Hospital Association criticized the report as making broad claims about pricing based on a cherry-picked and limited data set.
By Susan Morse | 05:15 pm | September 09, 2020
Expansion increases customer reach by 50% over last year, adding close to 80 new counties.
03:11 pm | August 31, 2020
In response to what AHIP said was price gouging, the organization has called for policy changes to stop the practice from continuing.
By Susan Morse | 08:57 am | August 25, 2020
Humana says it was billed millions of dollars for fraudulent prescription claims and members received unwanted expensive creams. 
By Susan Morse | 03:32 pm | August 21, 2020
The majority of health plans say they do not feel ready to meet the new FHIR interoperability standards mandated by CMS.
By Susan Morse | 03:36 pm | August 18, 2020
From October 1, 2019 to April 4, the flu killed from 24,000 to 62,000 Americans and caused at least 410,000 hospitalizations, according to the CDC.
By Susan Morse | 04:17 pm | August 10, 2020
The Energy and Commerce Committee calls for a reporting as AHIP says the next half-year could bring higher costs as the amount of care increases.
By Susan Morse | 10:05 am | July 06, 2020
The insurer will provide an additional $6 million in financial support to independent primary care physicians and community health centers.