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Claims Processing

By Susan Morse | 05:07 pm | April 29, 2021
The settlement resolves claims that the insurers violated antitrust laws by entering into an agreement not to compete with each other.
By Susan Morse | 06:53 pm | April 05, 2021
The Texas lawsuit claims UHC has advanced an "unlawful scheme" to eliminate providers like itself from its network for its own financial benefit.
By Kat Jercich | 03:57 pm | March 25, 2021
The vendor announced that it was collaborating with New York Life to facilitate and simplify EHR retrieval.
By Susan Morse | 11:26 am | March 19, 2021
Transcarent is offering at-risk contracts to share in employer savings.
By Mallory Hackett | 05:08 pm | February 25, 2021
The massive amount of data available in healthcare makes it a prime area for artificial intelligence and machine learning automation.
By Mallory Hackett | 04:43 pm | February 23, 2021
Similar to the COVID-19 vaccine, Medicare will cover these infusions for the duration of the public health emergency.
By Mallory Hackett | 04:10 pm | February 19, 2021
Although RAND said price regulation is the most effective way to reduce spending, the researchers said this method has the most opposition.
By Mallory Hackett | 04:45 pm | February 08, 2021
Prior authorization continues to be the area with the lowest adoption rate, with only 21% of medical plans having fully electronic transactions.
By Mallory Hackett | 05:07 pm | January 19, 2021
Rule requiring payers to implement APIs for data sharing and to streamline prior authorization is "half-baked," AHIP says.
By Mallory Hackett | 04:20 pm | January 15, 2021
The data will be used in a study to assess how physician practice mergers and hospital acquisitions of physician practices affect the marketplace.