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Claims Processing

By Mallory Hackett | 04:11 pm | November 04, 2020
When health systems have their staff manage revenue cycles, up to 25% of the day can be spent on repetitive tasks related to the revenue process.
By Mallory Hackett | 04:23 pm | October 29, 2020
FAIR Health attributes the increase in telehealth utilization to the pandemic, which forced nonemergency procedures to come to a halt in March.
By Susan Morse | 10:59 am | October 14, 2020
When Medicare open enrollment starts tomorrow, 2021 is expected to be the largest enrollment year for UHC's Medicare Advantage plans. 
By Susan Morse | 09:54 am | October 13, 2020
Affordable Care Act medical loss ratio rebates in 2021 will likely be exceptionally large across commercial markets. 
Communication between consumers and payers needs to be seamless, and all need to have access to the same health plan information, Zipari CEO says.
The American Hospital Association criticized the report as making broad claims about pricing based on a cherry-picked and limited data set.
By Susan Morse | 05:15 pm | September 09, 2020
Expansion increases customer reach by 50% over last year, adding close to 80 new counties.
In response to what AHIP said was price gouging, the organization has called for policy changes to stop the practice from continuing.
By Susan Morse | 08:57 am | August 25, 2020
Humana says it was billed millions of dollars for fraudulent prescription claims and members received unwanted expensive creams. 
By Susan Morse | 03:32 pm | August 21, 2020
The majority of health plans say they do not feel ready to meet the new FHIR interoperability standards mandated by CMS.