Effective payer provider collaboration is key to reducing the cost of healthcare, and claims management is an integral component of that relationship. As many organizations focus on care management, they
The healthcare payer landscape changes almost daily and it can be hard to see the forest through the proverbial trees. It’s easy to get focused on the day to day
New payment methods, accountable care, consumerism and an increasing demand for effective subscriber engagement and management (which disrupts traditional operating models in the small to mid-sized payer market) are placing
These are challenging times for healthcare payers. Increasing aging populations, pressure to cut costs, and a focus on quality is requiring everyone to do more with less. By facing these
Although the healthcare industry has made some progress in automating claims-related business processes, new findings in the 5th Annual CAQH Index show that widespread adoption of automation processes can result
Accountable care organizations (ACOs) were designed to shift the healthcare industry from the fee-for-service payment model to value-based care, but haven’t always achieved their intended objectives. Based on the successes
If you are one of the over 418,000 Medicare providers who participated in the 2017 MIPS reporting period, you may want to take a second look at your final score.
This past August, HCIM Colleagues gathered from across the country for corporate meetings and our annual giveback event in Houston, TX. This year, we hosted a summer social for residents
To offset the growing number of uninsured Americans, Congress enacted the Affordable Care Act (ACA) in 2010. With it came provision 9010, establishing the Health Insurance Providers (HIP) fee, a
The purpose underlying the International Classification of Diseases (ICD) manuals is to establish a common language to organize and identify diseases and their impacts on human lives. The recent release
Did you know that health insurance companies are already at work setting their premiums for 2019? This year, that endeavor may be more challenging than in previous years; politics, evolving
While many businesses are still looking for ways to harness new technology, Southern California Physicians Managed Care Services (SCPMCS) has been leveraging artificial intelligence to increase the productivity of their