The COVID-19 pandemic sent shockwaves through the healthcare industry, disrupting healthcare spending and utilization patterns, and leaving a noticeable impact on how we approach healthcare. Recent data from the Health
Maintaining Provider Data accuracy is one of the most common challenges for payers in the healthcare industry, and good reason. It can be overwhelming and, at times, very challenging to
Unexpected medical bills are a common issue that many patients face. In 2020, the Federal government passed the No Surprises Act to protect patients from these unexpected bills and increase
Health Plan Operations Health plan operations are complicated; increasing volume coupled with the demand for qualified claims professionals has made claims management in today’s world, difficult. Even beyond the demands
The only constant in healthcare is change. The landscape is constantly evolving, and all the players are feeling the heat to improve care delivery while making healthcare more affordable. There
Northern Nevada’s homeless, at-risk, aged-out foster youth is on the rise. A single night on the streets of Reno alone can claim up to 205 homeless youth under the age
Prior authorization has been a topic of contention ever since the strategy was proposed. While it certainly has benefits for healthcare payers, providers have been pressing CMS for reforms, and
If you’ve been keeping up with The Center for Medicare and Medicaid Innovation, or are employed by a health system, then you’ve likely seen the federal government’s new requirements in
As the healthcare industry continues to evolve, so do the technologies and systems used to manage and deliver care. In 2023, CMS (Centers for Medicare & Medicaid Services) will be
Ten years ago, telehealth and telemedicine barely existed. Sure, you might have gotten a call from your doctor or pharmacist for small things, but as far as healthcare is concerned,
If you’ve looked at claim denial data from 2020, you know that in-network claim denial rates were at an all time high. There are a lot of variables that go
Data management has been a huge topic of conversation lately, especially Provider data. To many, Provider data feels like it should stay a provider problem, the truth is that it