Health insurance plans serve as the financial backbone of health care, functioning as the crucial link between employers and providers in the $2.5 trillion industry. Topics include: claims management systems, quality improvement programs and claims processing standards.
The HealthShare Exchange of Southeastern Pennsylvania (HSXSEPA), the health information exchange for the five-county area surrounding Philadelphia, wasn't one of the first HIEs out of the blocks, but Executive Director Martin Lupinetti believes the organization, which tested its first live exchange of a CCD document in December 2013, is on solid ground.
As interoperability experts make connections, conference looks at wider data-sharing issues.
Unlike some other major industries, health care incorporates geospatial data only sparingly. But that could change quickly with population health a priority.
The Centers for Medicare and Medicaid Services has issued additional guidance on provider use of more standardized electronic funds transfer and electronic remittance advice transactions, and the mandate on health insurers to offer the transactions.
The Electronic Healthcare Network Accreditation Commission (EHNAC) and the Texas Health Services Authority (THSA), Austin, have announced the posting of TX-HIE accreditation program criteria for public review.
A move in Congress to delay the ICD-10 compliance date by one year to Oct. 1, 2015, could have some legs to it.
Emergency department usage in Massachusetts rose slightly both during and immediately after implementation of a 2006 state law expanding healthcare access, a sign that broader availability of insurance may increase use of the ED, Beth Israel Deaconess Medical Center researchers report in a study published in the Annals of Emergency Medicine.
The American Medical Association has new guidance documents to walk physician practices through the Affordable Care Acts insurance coverage grace period before a policy is cancelled for lack of payment.
Horizon Blue Cross Blue Shield of New Jersey, Newark, has begun to use COB Smart, a national registry that is currently identifying coordination of benefits for more than 100 million patients.
More than 50% of commercial insurer and third-party administrator (TPA) respondents indicate their organization is currently participating or planning to participate in a multi-carrier exchange, versus 20% in a single-carrier exchange. Given their prominence, Aite shares the following recommendations.
Employer healthcare cost management software vendor Castlight Health had a very successful initial public offering of stock on March 14, which is good news for emerging healthcare information technology companies. But some tempering of enthusiasm would be wise, counsels Paul Teitelbaum, managing director of the investment banking group at Mesirow Financial in Chicago.
I have witnessed firsthand the value of asserting the attorney/client privilege. Unfortunately, there seems to be a lack of awareness and understanding in leveraging this valuable tool which explains why I rarely see it invoked in healthcare.
With the October 1 ICD-10 implementation deadline looming, most national commercial health insurers say they are ready for the code change, according to a survey from the American Academy of Family Physicians.
Today is St. Patrick's Day, a sobering reminder that there are less than 200 days left until the October 1 ICD-10 implementation deadline. Either way, if you are a provider that is concerned about being prepared to make the code switchover, no one could blame you for having a good, strong drink (or two).
The Centers for Medicare and Medicaid Services is seeking volunteer providers, clearinghouses and suppliers to participate in end-to-end ICD-10 tracking with contractors in late July 2014. The deadline to submit an application form is March 24, 2014.