Browsing: payers

Three decades after HIPAA first mandated a standard for electronic claims attachments, we now have CMS-0053-F. This final rule establishes…

A new survey and report from MedCity News focuses on AI implementation by payers and integrated health systems as well…

Health plans face more pressure than ever before to deliver personalized member experiences, improve payment data accuracy, and reduce administrative…

America funds the crisis. It’s time to fund the care that prevents it. The post Dying Without a Safety Net…

The Medicare Advantage (MA) program has long occupied a unique space as a true public-private partnership in federal healthcare. Recent…

Healthcare has made real progress on interoperability, but we are still solving the wrong problem. We have APIs, standards, and…

Health insurers are keen to assess the value and effectiveness of AI applications across different parts of their businesses. But…

For decades, hospital revenue integrity teams have fought payer denials as if they were isolated transactions. A claim gets denied;…