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.
Medicare physician payment data shows that more than 1,000 primary care physicians providing hospital-based services billed Medicare more than five times the average, raising questions about their billing practices.
An initiative to help providers easily enroll to receive electronic funds transfer and electronic remittance advice from insurers got off to a slow start but has gained momentum in recent months.
A Pittsburgh medical nutrition therapy EHR developer spun out of Carnegie Mellon University in 2011 will place its Connect and Coach platform in more than 200 of West Des Moines, Iowa-based Hy-Vee's supermarket stores in eight midwestern states.
Making sense of the tide of health data inundating the U.S. healthcare community remains a daunting challenge for driving clinical and financial performance.
For years, in public opinion polls, people have tended to blame health insurers for premium increases and problems with their coverage. However, Americas Health Insurance Plans, the trade association representing payers providing health benefits for more than 200 million Americans, says it now wants to put consumers at the center of healthcare.
Healthcare is moving rapidly to incorporate measures of value into payment models, with more than two-thirds of payments expected to be based on value measurement in five years, up from just one third today.
Health plans have spent years and millions of dollars acquiring or replacing information systems but a lack of alignment between companies business and IT organizations is hamstringing the industry, according to a June 11 panel at Americas Health Insurance Plans Institute 2014 in Seattle.
At its annual meeting, the American Medical Association approved a list of guiding principles for ensuring the appropriate coverage of and payment for telemedicine services.
Americas Health Insurance Plans, the trade association for payers, is promoting new services to health consumers.
Data analysis from the Colorado Hospital Association finds states that expanded their Medicaid programs under the Affordable Care Act have fewer self-pay patients and lower hospital charity care rates.
The Office of the National Coordinator for Health Information Technology on Thursday released a paper outlining its 10-year vision for achieving a nationwide interoperable health IT infrastructure.
A new report on the adoption of bundled payment arrangements finds payers insisting on automating processes, a discrepancy in the speed of feedback data from commercial payers versus the Centers for Medicare and Medicaid Services, and a new appreciation among inpatient providers for the need to provide coordinated care.
LyfeChannel of San Carlos, Calif., which organizes cost and other information to support patient health decisions, was selected by the Office of the National Coordinator for Health IT as the winner of the second annual Code-a-Palooza Challenge.
Physicians practicing in a patient-centered medical home with an electronic health records system provide more recommended care than counterparts not in a medical home and using paper or electronic records.
Claims clearinghouse and revenue cycle management software vendor Availity has made an acquisition to aid provider organizations in an era of increasing patient payment responsibility.