Five key functions must be included in your provider-facing portal
Predictive analysis can link suspicious behavior back to fraudsters before claims are paid out
To achieve a higher rate of clean claims, health plans have to be absolutely clear on what a "clean claim" means to all parties in the transaction.
A decade ago, health plans barely raised an eyebrow at specialty pharmaceuticals, however, this under-the-radar segment began to explode
For technology professionals leading IT efforts among health plans, the biggest changes haven't come from hardware and software, but rather, from their roles in implementing new business concepts.
A recent national sampling of 34 insurers' EOBs by DALBAR, a third-party communications evaluation firm, gave 68% of the EOB statements it analyzed a failing grade.
Physicians have historically been lacking in collecting on bad debt, and now the cost of tracking it down might not be worth it
Activity and progress increase on the exchange of health information electronically between physicians, hospitals, plans and patients, while cost savings have been identified.
A new released by the Cooperative Exchange (CE) sheds new light on claims transactions, revealing just how big a footprint EDI has