Claims Processing

Payers test risk contracts with big pharma
May 08, 2017 | Susan Morse
As analytics programs look for population data, some contracts are shifting accountability to drugmakers.
New claims processing systems for insurers
May 08, 2017 | Susan Morse
New claims processing systems cost up to $300 million, so insurers are looking to outsource instead.
Claims processing
May 08, 2017 | Susan Morse
Automation is helping, but what is really needed is a standard approach.
Payer contract negotiations
May 05, 2017 | Susan Morse
It's usually best to understand your claims data, update chargemasters, before sitting down at the table.
Mount Sinai owes OIG $42 million
May 04, 2017 | Bernie Monegain
New York hospital owes millions for improperly billed Medicare claims in 2012 and 2013, but the recovery period…
Apr 26, 2017 | Jeff Lagasse
Spending bloat, "patchwork" regulations, unstable markets are a problem for reform efforts, experts said.
blockchain in healthcare payer and providers
Apr 24, 2017 | Susan Morse
The next big healthcare technology innovation will increase transparency and save money.
Mar 28, 2017 | Jeff Lagasse
Both Cognizant and HSP scored high marks for adaptability, viewed as important in a landscape dominated…
Mar 15, 2017 | Jeff Lagasse
The South Central region had the second-highest rate, according to RelayHealth Financial's…
Feb 08, 2017 | Susan Morse
Judge also ruled that Humble Surgical Hospital in Humble, Texas, was paying 30 percent kickbacks for facility fees to…