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.


Taking the Guesswork Out of Prior Authorization

Aetna to Phase Out CarePass Health, Wellness Platform

How well are Your Mobile Apps Vetted?

CMS Database Fails to Accurately Track RAC Activity

Medicaid Patients Not Overusing Emergency Departments

Telemedicine Could Yield $6B Annually in Healthcare Savings

HumanaVitality Releases Mobile Wellness App

Facility Fees Are Wild Card in Cost Variations

Bill Authorizes Value-Based Medicare Advantage Demo

California Payers Bet $80M on Statewide HIE

CMS Gives a Push to Skilled Nursing HIE

CMS Restarts Parts of the RAC Program

Using ‘Behavioral’ DNA to Hire the Right Candidate

What to Do About Stage 2

Small Physician Practices Face Barriers in Using Telemedicine

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