Healthcare Dive

APRIL 19, 2022

As a last resort, the No Surprises Act allows payers and providers to resolve payment disputes using arbitration. The online site that initiates the process is now open.

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Healthcare Dive

OCTOBER 17, 2022

Volatility in MA stars for the 2023 plan year is raising questions around the earnings outlooks issued by payers.

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MRO Compliance

JUNE 5, 2023

Innovation Between Payers and Providers June 5, 2023 Healthcare Innovation Sanket Baralay, Chief Innovation Officer at MRO, and Matthew Raynor, Group Publisher at Healthcare Innovation, discuss the ongoing challenges between payers and providers, especially when it comes to reimbursement and compliance. View Full Article

Compliance 130

Compliance 130

Healthcare Dive

OCTOBER 28, 2022

The payer has been steadily ratcheting up its presence on the Affordable Care Act exchanges after dramatically reducing its footprint in 2017.

ACA 340

ACA 340

Healthcare Dive

JANUARY 21, 2022

The sectors face continued operational pressure as they head into a third year of the pandemic, including a tight labor market and shifts in payer mix.

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MRO Compliance

JULY 26, 2023

Because data allows for better decision-making, patient records are being requested by payers, communities of care, and patients themselves. However, this can sometimes be overwhelming for healthcare provider organizations that are now getting larger and larger volumes of requests from payers which inundate their systems.

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Fierce Healthcare

APRIL 24, 2024

WebMD Ignite is launching a new suite of tech tools it says will help payers turbocharge their clinical programs. WebMD Ignite is launching a new suite of tech tools it says will help payers turbocharge their clinical programs.

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HIT Consultant

APRIL 9, 2024

To address the benefit needs of underrepresented population groups, payers can develop “more equitable approaches to healthcare benefits design that recognize and meaningfully address access and affordability concerns,” according to a 2022 article in the American Journal of Health Promotion.

COVID-19 97

COVID-19 Health Outcomes 97

Fierce Healthcare

APRIL 2, 2024

Virtual care navigation platform Pager Health has built three new enterprise tools using Google Cloud generative AI technology to better support its payer partners. Pager Health revealed three new tools for payers powered by Google on Wednesday.

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MRO Compliance

MARCH 7, 2024

(MRO), the leading clinical data exchange company in healthcare, announced that Frank Jackson has joined the company as its new Senior Vice President of Clinical Quality and Payer Solutions. In this new role, Jackson will function as the General Manager (GM) of MRO’s growing clinical quality and payer solutions business.

Hospitals 133

Hospitals 133

HIT Consultant

MARCH 17, 2024

Payers have the added complexity of managing accurate directories that include information about retail health centers, fragmented medical histories, and patient engagement. By working together with authentic data, both payers and retail health centers have a unique opportunity to significantly impact patient care.

Patient Satisfaction 111

Patient Satisfaction Health Outcomes COVID-19 Doctors 111

MedTrainer

APRIL 25, 2024

Below is an Arizona healthcare payer list with information on some of the insurance organizations doing business in the state. Watch Now Use This Arizona Healthcare Payer List and MedTrainer To Simplify Enrollment Consider that enrolling one provider with one payer can take 4-8 hours of uninterrupted time.

Licensing 52

Licensing Hospitals 52

Medisys Compliance

MARCH 5, 2024

Introduction Cardiology billing presents unique challenges due to evolving regulatory landscapes, complex coding requirements, and the constant scrutiny of payer audits. This article explores into the details of cardiology billing, offering insights into payer audits and reimbursement challenges in cardiology billing.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medical Billing Compliance Governance 105

MedTrainer

APRIL 24, 2024

However, only a few payers can be considered nationwide. If you’re a provider looking for a multi-state expansion of your practice, check out the national healthcare payer list below. That makes this national healthcare payer list even more welcome! With nearly 1,100 health insurance companies in the U.S.,

Licensing 52

Licensing Health Insurance Hospitals 52

Fierce Healthcare

JANUARY 12, 2024

Industry giant UnitedHealth Group kicked off fourth-quarter earnings for major payers on Friday morning, where it reported $5.5 Industry giant UnitedHealth Group kicked off fourth-quarter earnings for major payers on Friday morning, where it reported $5.5 billion in profit. billion in profit.

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Healthcare IT Today

MARCH 21, 2024

This includes an important focus area of MRO to be able to share data between providers and payers. Through such efficiencies, they reduce the burden on providers while letting payers build up longitudinal records on patients. Murray shares some of the solutions MRO has put in place to navigate around these challenges.

Hospitals 101

Hospitals 101

MedTrainer

APRIL 25, 2024

Below is a Texas healthcare payer list with information on some of the insurance organizations doing business in the state. Watch Now Use This Texas Healthcare Payer List and MedTrainer To Simplify Enrollment Consider that enrolling one provider with one payer can take 4-8 hours of uninterrupted time.

Licensing 52

Licensing Hospitals 52

Fierce Healthcare

MARCH 11, 2024

The federal government is pressing UnitedHealth Group and other payers to provide financial relief to providers as they continue to feel the financial disruption caused by the Change Healthcare cyb | The federal government is pressing UnitedHealth Group and other payers to provide financial relief to providers as they continue to feel the financial (..)

Governance 127

Governance 127

MedTrainer

APRIL 25, 2024

A New York healthcare payer list could come in handy! Below, you’ll find a New York healthcare payer list with information on some of the insurance organizations doing business in the state. Payer Address Where to Join Phone Amida Care Inc. The post New York Healthcare Payer List for Providers appeared first on MedTrainer.

Licensing 52

Licensing Hospitals 52

Healthcare Dive

JUNE 3, 2022

The amount reflects the third-straight year of massive insurer rebates as payers experienced high profits from the COVID-19 pandemic.

COVID-19 315

COVID-19 315

MedTrainer

APRIL 24, 2024

Below is a California healthcare payer list with information on some of the insurance organizations doing business in the state. Payer Address Where to Join Phone Alameda Alliance 1240 South Loop Road Alameda, CA 94502 Provider Portal (510) 747-4500 Anthem Blue Cross 21215 Burbank Blvd.

Community Health Groups 52

Community Health Groups Licensing Governance Hospitals 52

MRO Compliance

SEPTEMBER 19, 2023

Health information (HI) professionals nationwide anticipate a looming tsunami of payer requests for medical records. During a RADV audit, CMS confirms that any diagnoses submitted by payers for risk adjustment are supported in the enrollee’s medical record. And each new season brings an increasing number of payer requests.

Medicare 130

Medicare Medicare Medicaid Medicaid 130

MRO Compliance

MAY 24, 2023

Innovation in Payer and Provider Data Exchange: On-Air Insights I recently had the pleasure of speaking with Beth Friedman, Senior Partner at FINN Partners, as a guest on the FINN Voices show on Healthcare NOW Radio. The topic was innovation in payer and provider data exchange. And they can reduce payer-provider friction along the way.

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Healthcare Dive

AUGUST 9, 2023

The study, published in Health Affairs, found large national insurers had higher price ratios than other payers.

Hospitals 245

Hospitals 245

MRO Compliance

JUNE 26, 2023

MRO Launches New Solution to Innovate Clinical Data Exchange Between Providers and Payers Payer Exchange reduces administrative burdens for providers and payers during risk adjustment and other reviews while closing costly reporting gaps. Norristown, Pa. June 26 , 2023 – MRO Corp., June 26 , 2023 – MRO Corp.,

Hospitals 130

Hospitals 130

Healthcare IT Today

FEBRUARY 21, 2024

This Acquisition Positions Chartis to Help Clients Achieve Transformational Healthcare Change Chartis , a leading healthcare advisory firm, today announced that it has acquired HealthScape Advisors , a leading healthcare payer consulting firm. I look forward to integrating our firm into Chartis.”

ACA 95

ACA Medicaid Medicaid Medicare 95

Fierce Healthcare

FEBRUARY 9, 2024

Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023. Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023.

Medicare 118

Medicare Medicare 118

HealthIT Answers

APRIL 3, 2024

Reported payers and health insurance industry news from Xsolis, AHIP, Humana, Independence Blue Cross, CVS Health, Blue Cross and Blue Shield, CareSource, and more. The post Revenue Cycle and Payer News – April 3, 2024 appeared first on Health IT Answers.

Health Insurance 59

Health Insurance 59

Healthcare IT Today

FEBRUARY 21, 2024

Additionally, the absence of universally accepted standards impedes the seamless flow of information between healthcare providers, payers, and other stakeholders. Both providers and payers may be accustomed to operating within siloed systems, and the prospect of adopting interoperable practices can be met with reluctance. InteropNow!

Compliance 109

Compliance HIPAA Hospitals 109

MRO Compliance

OCTOBER 30, 2023

Too often today, relations between provider and payer organizations can become contentious around issues related to payment and quality of care. With this purpose in mind, LifeBridge Health, a health system with 1,200+ beds and 120 physicians, and CareFirst BlueCross BlueShield (CareFirst), a payer organization with about 3.5

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Fierce Healthcare

JANUARY 22, 2024

The Biden administration’s healthcare regulators released new guidances, informational resources and other actions that reinforce payers and hospitals’ federal obligations surrounding reproductive | New letters and instructional materials out of HHS come amid reported contraception coverage barriers and escalating legal challenges over emergency abortion (..)

Hospitals 110

Hospitals 110

MRO Compliance

FEBRUARY 6, 2023

Payer Plugs Gap with Innovative Alliance February 6, 2023 Health Payer Specialist And to gather additional contextual data that is not included in the claims data, CareFirst has partnered with Rockford, Ill.-based It’s a gap for providers and for the payers,” said Rabovsky. It’s a gap for care managers.

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Healthcare Dive

JANUARY 5, 2024

More than 90% of hospitals posted files at least partially compliant with price transparency requirements in 2023, according to a new report from Turquoise Health.

Hospitals 269

Hospitals 269

Fierce Healthcare

FEBRUARY 23, 2024

Online therapy company Talkspace is doubling down on its strategy to grow its business with payers and employers with a focus on providing services to teens and seniors. Online therapy company Talkspace is doubling down on its strategy to grow its business with payers and employers with a focus on providing services to teens and seniors.

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109

HealthIT Answers

MARCH 6, 2024

Reported payers and health insurance industry news from Highmark Health, Humana, Independence Blue Cross, CVS Health, Blue Cross and Blue Shield, UnitedHealth Group, Cigna, Cambia Health Solutions, and more. The post Revenue Cycle and Payer News – March 6, 2024 appeared first on Health IT Answers.

Health Insurance 59

Health Insurance 59

Fierce Healthcare

DECEMBER 13, 2023

A jump in claim delays and denials is “wreaking havoc on providers’ revenue cycle performance” and contributing to health systems’ “volatile” accounts receivable and diminishing cash reserves, acco | More frequent pushback from commercial and Medicare Advantage payers is complicating patient self-pay collections and, ultimately, undermining the revenues (..)

Medicare 131

Medicare Medicare Hospitals 131

Fierce Healthcare

APRIL 5, 2024

Payer Roundup—Blue Cross Blue Shield Association lawsuit unfolds; Rightway raises $109M; Surescripts reportedly eyes sale ntong Fri, 04/05/2024 - 16:02

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