Claims Processing

The RADV final rule comes after increasingly high profile instances of apparent over coding from Medicare Advantage Organizations.

<div style="position: relative; display: block; max-width: 100%;"> <div style="padding-top: 56.

Digital cloud faxing can remove manual processes for greater efficiencies

Centene made no admission of liability and maintained its business practices are lawful. 

The groups indicate further court action is coming due to continued problems with the interim and final rules.

The departments say they have received "substantially more" disputed claims than expected. 

Here are some tips for your next optimization, starting with identifying KPIs to creating an ongoing optimization culture.

<p style="text-align:start; margin-bottom:11px"><span style="font-size:11pt"><span style="line-height:15.546667098999023px"><span style="font-family:Calibri, sans-serif"><span style="color:#000000"><span style="font-style:normal"><span style="font-weight:normal"><span style="white-space:normal"><span style="text-decoration:none">Mark Martin, vice president of product management for Availity, discusses how the company employs AI and machine learning to assist providers and payers in streamlining referrals, approvals and claims management.</span></span></span></span></span></span></span></span></p> <p> </p>

Starting next month, health plans will cover at-home tests for the 150 million Americans with private health insurance, President Biden says.

The report's release coincides with the No Surprises Act taking effect on January 1, 2022.