Claims Processing
HIMSS22
<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>
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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.
One claim for over $1,700 was for a 23-year-old man treated in the ER for indigestion after eating a chili dog, lawsuit says.
Hospitals can decrease denials by having physicians involved in the mid-revenue cycle review process.
Telehealth made up 4.5% of medical claim lines in June, falling from 5% in May.
It has expanded its product portfolio in states where it already does business, including Florida, California, Colorado and North Carolina.
DomaniRx is an API-driven claims adjudication platform representing the next generation in PBMs.
Q&A with Availity's Lillian Phelps on the challenges of claim attachments, denial management and prior authorizations.
Providers will be able to send prior authorizations through Epic instead of using phone or fax.