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.
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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 Zac Amos – Social engineering and other interpersonal tactics are rising in frequency in the medical sector, so what red flags should medical professionals look for when identifying insider threats?
By Gary Hamilton & Celissa Halfhill – Some patient populations are harder to engage than others. No one understands this better than Community Health Centers, who tirelessly serve marginalized communities often overlooked by traditional healthcare systems.
By Michelle Padilla – Humans are often the weakest point of any cybersecurity system, but fortunately there are some easy practices you can personally put into place to make the online posture of both you and your healthcare organization more secure.
By Devin Partida – While patients are fundamental to the healthcare industry, they often get left out of the conversation. In the interest of improving outcomes and increasing engagement, information technology teams must design patient-centered websites. How should they go about it?
By Richa Jain – While it is clear that technology is opening new horizons for medical practices, we can’t ignore the fact that healthcare RCM is one sprawling operation; it encompasses processes starting from patient registration to collections and needs a tech overhaul.
By Lance Reid – Protecting patient data is a non-negotiable priority for healthcare organizations. Yet, as cybersecurity breaches become more frequent and sophisticated, the stakes for healthcare IT security are higher than ever.
By Laurie Seall – Data that sits in a legacy system is at risk of becoming inaccessible. As applications and servers age, they become more vulnerable to cyberattacks and downtime. As the need for data agility and efficiency continues to evolve, it is important to do some cleanup work that will pay off for years to come.