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Claims Processing

By Mallory Hackett | 05:23 pm | October 29, 2020
FAIR Health attributes the increase in telehealth utilization to the pandemic, which forced nonemergency procedures to come to a halt in March.
By Susan Morse | 11:59 am | October 14, 2020
When Medicare open enrollment starts tomorrow, 2021 is expected to be the largest enrollment year for UHC's Medicare Advantage plans.
By Susan Morse | 10:54 am | October 13, 2020
Affordable Care Act medical loss ratio rebates in 2021 will likely be exceptionally large across commercial markets. 
04:52 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.
11:45 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 | 06:15 pm | September 09, 2020
Expansion increases customer reach by 50% over last year, adding close to 80 new counties.
04:11 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 | 09:57 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 | 04:32 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 | 04:36 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.