By Pavani Munjuluri – When it comes to intelligent process automation (IPA) in healthcare, multiple stakeholders drive technology adoption. Payers, providers and patients all bring their own unique interests and perspectives on how healthcare should operate and in what areas IPA should be used.
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Latest news being reported on payers and the health insurance industry including news from Blue Cross Blue Shield Association, CarePlus Health Plans, CareSource, Humana, Independence Health Group, Cigna, AHIP, Molina Healthcare, Priority Health, UnitedHealthcare, Anthem Inc., CVS Health and more.
By David Shelton – A staggering 90% of physicians say manual prior authorizations are a concern, according to the 2019 CAQH Index. Further magnifying the current situation are payers’ intentions to increase prior authorization requirements for even more services in the near future.
By Pamela J. Gallagher – Patients have been begging for affordability for decades, and the healthcare industry’s reluctance to innovate and adapt to patient demands has left a door open for retailers to move into the healthcare business. I believe this will be great for healthcare, but potentially disastrous for health systems.
Latest news being reported on payers and the health insurance industry including news from Cohere Health, Humana, HST, UnitedHealthcare, Anthem, Bind Benefits, CVS Health, Blue Cross Blue Shield Association, Cigna Corporation, Oscar Health, Aetna and more.
By Angela Jordan – The Transitional Care Management codes (99495, 99496) introduced in 2013 allow providers to report and capture reimbursement for the work involved with providing continuity of care to patients discharged from a hospital or other qualified stay, back into their community setting.
By Emad Rizk MD – COVID-19 exposed many weaknesses in our healthcare system and exacerbated fraud, waste and abuse. As the federal government waived restrictions around various reimbursements for Medicare patients as well as encouraged plans to be more…
By Pamela J. Gallagher – In 2019, emergency departments across the U.S. saw an average of 2.1 million patients per week, according to the CDC. Over the past several decades, healthcare organizations have invested large amounts of money, time, and effort to study the trend of…
NAACOS reported that Medicare’s largest alternative payment model by far had another record year of savings while continuing to provide high-quality care, as shown by data on 2019 performance released by CMS. Check out ACOs reporting savings.