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Claims Processing

By Susan Morse | 09:55 am | January 15, 2021
Getting paid has become imperative during a time when both hospitals and patients may be cash-strapped.
By Mallory Hackett | 04:21 pm | January 06, 2021
Northwell reportedly sued thousands of patients last year for unpaid medical bills averaging $1,700.
By Mallory Hackett | 04:18 pm | January 05, 2021
The report found that 53% of hospitals in the bottom quartile of the area wage index for 2020 were in rural areas.
By Susan Morse | 10:14 am | December 23, 2020
Consumer Reports hails passage as being good for providers who feel pressured into contract terms that benefit insurers.
By Mallory Hackett | 11:18 am | December 22, 2020
Negotiations of drug prices are to be based on clinical outcomes; if the drug is not effective, the payer is not held accountable for the full price.
By Mallory Hackett | 10:16 am | December 18, 2020
The new opportunity will test how financial risk-sharing can reduce Medicare expenditures while preserving the quality of care for beneficiaries.
By Mallory Hackett | 03:28 pm | November 25, 2020
In a recently announced merger with the larger Intermountain system, CEO Kelby Krabbenhoft was to serve as president emeritus.
By Mallory Hackett | 04:28 pm | November 24, 2020
Risk adjustment data validation ensures payment integrity and accuracy - and it affects what plans are paid.
By Susan Morse | 03:35 pm | November 17, 2020
Payers, employers, organized medicine and researchers can alter the mounting financial and clinical barriers patients face, the AMA says.
By Mallory Hackett | 03:54 pm | November 10, 2020
The rule seeks to reduce federal regulatory barriers, support adaptability and promote transparency and innovation.