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Claims Processing

By Susan Morse | 02:03 pm | December 03, 2021
Starting next month, health plans will cover at-home tests for the 150 million Americans with private health insurance, President Biden says.
By Susan Morse | 11:11 am | November 23, 2021
The report's release coincides with the No Surprises Act taking effect on January 1, 2022.
By Susan Morse | 10:48 am | October 29, 2021
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.
By Susan Morse | 10:34 am | October 22, 2021
Hospitals can decrease denials by having physicians involved in the mid-revenue cycle review process.
05:08 pm | September 13, 2021
Telehealth made up 4.5% of medical claim lines in June, falling from 5% in May.
By Susan Morse | 11:45 am | August 20, 2021
It has expanded its product portfolio in states where it already does business, including Florida, California, Colorado and North Carolina.
By Susan Morse | 10:03 am | July 27, 2021
DomaniRx is an API-driven claims adjudication platform representing the next generation in PBMs.
By Susan Morse | 05:40 pm | June 23, 2021
Q&A with Availity's Lillian Phelps on the challenges of claim attachments, denial management and prior authorizations.
By Susan Morse | 10:35 am | May 20, 2021
Providers will be able to send prior authorizations through Epic instead of using phone or fax.
By Susan Morse | 06:07 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.