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In the healthcare ecosystem, a payer is any entity such as a private insurer or government program, that finances or reimburses the cost of health services. Health plans, offered by these payers, provide specific coverage for various medical needs. These plans may be administered by private insurers, or government programs. Each health plan comes with distinct data collection requirements, which are essential for accurate risk adjustment and sustainable payment models.
Kaiser's investment in Clarium comes as supply chain management is a growing concern for providers as natural disasters and tariffs threaten the flow of goods.
Republicans’ plan to reduce spending on Medicaid would eliminate waste, fraud and abuse, the HHS secretary said in hearings Wednesday. Millions could become uninsured under the proposal.
Discover everything healthcare providers need to know about secure messaging. Covering essential topics like HIPAA compliance, communication efficiency, and patient privacy protection, this resource is indispensable for professionals, caregivers, and administrative staff alike.📱 💬 Whether managing sensitive patient data, coordinating care teams, or streamlining workflows, discover actionable insights to implement secure messaging solutions effectively.
By Frank Forte - Despite the widespread adoption of electronic health record systems and advances in interoperability, healthcare organizations continue to face significant hurdles in managing their revenue cycle operations, particularly when handling the most challenging areas of reimbursement. The post Cross-Industry Partnerships: Navigating Healthcare’s Complex Reimbursement Landscape appeared first on Health IT Answers.
Digital health service Immedicare says it helped thousands of Liverpool care home residents avoid unnecessary hospital visits in 2024.
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Health Care Compliance Brief brings together the best content for health law & compliance professionals from the widest variety of industry thought leaders.
Investment is Aimed at Accelerating Yunu’s Pharma Sponsor and Site Network Growth Yunu , provider of transformative clinical trials imaging workflow solutions, secured an investment led by Spring Mountain Capital , affirming Yunu’s position as an emerging category leader and proven innovator within the clinical trial imaging market. Yunu’s platform delivers next-generation trial imaging workflow and ensures fast delivery of operational and clinical insights to sponsors. “
The following is a guest article by Daniel Stein, MD, Founder and CEO at Embold Health Finding a doctor should be simple, but it rarely is. Search engines return hundreds of results. Online reviews tell conflicting stories. A friend or family recommendation, though provided with good intentions, might not be the best fit. The process for finding a good healthcare provider is often overwhelming, unclear, and can lead to the wrong care.
Speaker: Simran Kaur, Co-founder & CEO at Tattva.Health
AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!
We’re excited to be back for another episode of the Life Sciences Today Podcast by Healthcare IT Today. I took over for Danny this episode to sit down with Mark Klarzynsk, CSO and Co-Founder at PEAK:AIO , to talk about AI-powered data! We kick this episode off by discussing the healthcare industry’s current status with AI-powered data infrastructures.
Many medical practices strategize and work hard to experience growth. It can be exciting and rewarding. Increased growth is often accompanied by increased revenues, along with an opportunity to positively impact the health of more people.
RISA Labs Reduces Prior Authorization Times 10x, Helping Cancer Patients Access Life-Saving Treatment Faster Cancer patients dont just fight the disease – they fight the system. Today, life-saving treatments are routinely delayed by days or even weeks due to manual, error-prone workflows. To solve this, RISA Labs has raised a $3.5M funding round to help healthcare organizations eliminate one of the most persistent barriers to timely cancer care: prior authorization delays.
Health care continues to drive private equity (“PE”) activity, creating opportunities for investors and traditional health care providers. Transactions in the health care space are especially complicated, layering health care regulatory and reimbursement considerations on top of a complex securities, antitrust, privacy and security framework.
Based on comprehensive survey data from diverse healthcare providers, the 2025 HIPAA Benchmark Report delivers actionable intelligence for modern compliance programs. This report examines how organizations are restructuring HIPAA Privacy Programs to address emerging regulatory requirements. Through analysis of staffing models, program operations, and breach management protocols, it provides a clear picture of current best practices.
Business and financial news from Infinx, NextGen Healthcare, InteliChart, Ambience Healthcare, Modivcare Inc., Fortified Health Security, Centauri Health Solutions, MedAllies, Teladoc Health, Lyric, ModMed, Radware, Acentra Health, Supreme Group, IKS Health, Carta Healthcare, Yosi Health, CereCore and more. The post Health IT Business News, Financial Edition – May 15, 2025 appeared first on Health IT Answers.
Facing uncertainties across everyday life flows, U.S. consumers look to economic and health security — and welcome businesses to support these, we learn in an analysis from The Conference Board. The Conference Board (TCB) polled 3,000 U.S. consumers gauging their perspectives on uncertainties emerging out of the new Trump administration’s policy changes introduced in the first quarter of 2025.
Medical device verification is a critical process that ensures medical products meet their intended use, quality requirements, and safety standards before reaching the market. In an industry where patient safety is the highest priority, verification acts as a safeguard, thoroughly examining the device’s design, materials, manufacturing processes, and performance.
Every health care provider that accepts federal payments must screen for excluded providers. Use this sample Exclusion Screening Checklist and Compliance Policy to evaluate and improve your organization’s compliance with the law. Payments from Medicare, Medicaid, and TriCare trigger screening requirements that may extend to employees, contractors, volunteers, board members, and network providers.
Iodine Software's pre-bill solution can identify an extra 25% revenue savings per month for health systems after a patient is discharged. The savings could help justify investment in other AI products.
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