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In Brief: An auditor’s first question about a claims AI decision is usually: why was this determination made on this date? Most health plans can show today’s denial reason...
The Centers for Medicare & Medicaid Services estimated a Medicaid improper-payment rate of 6.12% for...
ROPA is a provider enrollment rule that turns into a health plan data problem....
Identity tells you who the provider is. Evidence tells you whether the record is...
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In Brief: An auditor’s first question about a claims AI decision is usually: why...
Closing the Books with Confidence | How Perpetual Reconciliation Ends Month-End Pain for Healthcare...
Surviving the HR1 Trillion-Dollar Tremor: Operational Readiness for Mid-Market Medicaid Plans In Brief:...
The $57 Claim Denial Treadmill | Why Health Plans Are Spending More to Lose...
CMS-0057 Compliance Countdown: FHIR API Mandate – Why Mid-Market Payers Need a Faster Path...
CureIS Healthcare has filed a lawsuit against Epic Systems in U.S. federal court, alleging the EHR giant used its market power and an “Epic first” approach to push customers away from CureIS and suppress competition in managed care data reconciliation software.
What the HIPAA Security Rule Changes Mean for Mid-Market Payers, And How to Accelerate...
Healthcare systems can finally talk to each other. Too often, they're not saying anything...
The Challenge Arizona and Hawaii Share: Medicaid Encounter Data in Capitated Managed Care If...
