Maximize messaging in EOB statements
A recent national sampling of 34 insurers' EOBs by DALBAR, a third-party communications evaluation firm, gave 68% of the EOB statements it analyzed a failing grade.read more
View ArticleHealth IT leadership must drive big-picture strategies
For technology professionals leading IT efforts among health plans, the biggest changes haven't come from hardware and software, but rather, from their roles in implementing new business concepts.read...
View ArticleClean claims slide easily through autoadjudication systems
To achieve a higher rate of clean claims, health plans have to be absolutely clear on what a "clean claim" means to all parties in the transaction.read more
View ArticleLocate overpayments in complex claims adjudication processes
A decade ago, health plans barely raised an eyebrow at specialty pharmaceuticals, however, this under-the-radar segment began to exploderead more
View ArticleHIEs leave positive mark
Activity and progress increase on the exchange of health information electronically between physicians, hospitals, plans and patients, while cost savings have been identified.read more
View ArticleSurvey reveals EDI claims volume
A new released by the Cooperative Exchange (CE) sheds new light on claims transactions, revealing just how big a footprint EDI hasread more
View ArticleFederal incentives up e-prescribing
CMS is sending a message that all prescribers must begin using electronic tools to increase safety and reduce costs. Commerical payers are onboard.read more
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