CMS Changes Affecting ACOs in 2023
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
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
Los Angeles is known for many things: the glittering lights, star-studded neighborhoods, unique culture, and Rodeo Drive. The last place that people think of when visiting Los Angeles is Skid
If you are in healthcare, you’ve likely heard of the recently released Annual Report of the Departments of Health and Human Services and Justice. The Health Care Fraud and Abuse
The healthcare sector is continually evolving. Just about everything can cause a ripple effect, no matter how big or small the change might seem right now. The tiniest shift, like
If you’re in health plan operations, you’ve likely heard about the latest technologies hitting the market. It seems like every other day, there’s some new this or that to make
There are many contributing factors to the ebb and flow of insurance premiums, especially in the commercial market. The economy, the pulse of the country, and the slightest change in
Hunger in the US is a largely hidden issue that is far more widespread than most know. The pandemic compounded this, and left many families struggling to meet their basic
If there is anything positive to take away from the Covid-19 era it would be how it forced health plans and providers to work together and face the tidal wave
Every year, thousands (yes, thousands) of Medicare, Medicaid, and CHIP (Children’s Health Insurance Program) payments are paid in error. Whether that is through overpayment on a claim, underpayment, duplicate payments,
It’s not as complicated as you might think If there’s one thing that’s been brought to the forefront post-2020, it’s the turnover rate in administrative healthcare positions like claims processors.
At its core, Value-Based Care seems like a no-brainer for the healthcare industry. Simply put, this model rewards providers with incentives based on the quality of the care they provide
In many ways, ICD-10-CM is quite similar to ICD-9-CM. The guidelines, conventions, and rules are very similar. The organization of the codes is also very similar. Anyone who is qualified