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Claims Processing

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.
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.