By Kendra Obrist – ASTP’s FHIR Action Plan is a welcome development for those of us who have long seen HL7 FHIR as a cornerstone of interoperability. With the ASTP’s focus on FHIR, we are moving closer to a fully interoperable healthcare ecosystem.
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By Chris Bowen – In recent years, blockchain technology has emerged as the buzzword across multiple industries, promising to revolutionize processes with its decentralized and secure framework. In the healthcare sector, it has been hailed as the solution to longstanding challenges.
By Kim Boyd – A recent study published in Health Affairs examined the current state of Health Information Organizations and their engagement with TEFCA. TEFCA represents a major leap toward creating a unified federal health information exchange, but the study reveals a mix of optimism and hesitancy across the industry.
By Dan Healy and Michael Lipinski – In this blog post we share concerns that have been brought to our attention pertaining to potential violations of the information blocking regulations by health care providers as well as developers of certified health IT.
As Cybersecurity Awareness Month draws to a close, the lessons learned should not be forgotten. Cybersecurity is an ongoing challenge that requires constant vigilance, training, and adaptation. #BeCyberSafe
By Mike Lanza – In the stop-loss industry, on occasion there can be tension between the Claim Payer (payer or TPA) and the Stop-Loss carrier when it comes to determining reimbursing claims that exceed the specific deductible. Most claims payers have a claims review process in place to ensure that claims payment follows the Employer’s Plan document.
By Conrad Coopersmith – The evolution of computer-assisted coding, computer-assisted professional coding, and artificial intelligence in revenue cycle management and medical coding is impacting how healthcare information is processed, coded, and managed.
By Dr. Gavin Magaha PharmD MS – The current turmoil surrounding the 340B Drug Pricing Program and Medicaid Drug Rebate Program. Bloomberg Law, recently reported that pharmaceutical manufacturers and a trade organization have filed at least 23 that extend 340B drug discounts to an unlimited number of contract pharmacies.
By Justin Barnes & Greg Fulton – Explaining new CMS policy allowing concurrent CCM and RPM billing for qualified patients, and examination of how chronic care dominates healthcare spending and the opportunity to embark on value-based care revenue streams through MIPS and ACO programs.