Claims Processing
Healthcare providers may now apply to participate in a new program known as the Bundled Payments for Care Improvement Initiative (shortened to Bundled Payments Initiative [BPI]).
An alarming article in Politico.com looks at what could happen if the Supreme Court determines that the Affordable Care Act’s individual mandate provision is unconstitutional—something that the current conservative leaning of the Court seems to indicate is somewhat more likely than not.
The Centers for Medicare & Medicaid Services has taken its national 5010 testing days to the next level: a whole week – Aug. 22 to 26 – dedicated to testing in advance of the Jan. 1, 2012 compliance date.
The Medicaid Recovery Audit Contractors (RACs) could be gearing up to hit providers if one contractor’s quarterly report is any indication.
Many self-help gurus will say it's not helpful to compare yourself to others but a new study released Thursday comparing the administrative costs of physicians' offices in the United States and Canada brings home the point that standardizing administrative operations reduces costs and lessens hassles.
Detailing a laundry list of potential benefits to its health plan clients, their members and company shareholders, Express Scripts announced today a definitive merger agreement with competing pharmacy benefits management company Medco - a deal valued at $29.1 billion.
Data mining is both an art and science. Roughly stated, the purpose is to extract useful information from data.
The Department of Health and Human Services (HHS) took the first steps to implement an Affordable Care Act provision that cuts red tape in the healthcare system and saves an estimated $12 billion over the next ten years.
Payers are on track for the implementation of ICD-10 and do not anticipate problems with processing payments -- at least according to Ian Bonnet, vice president leading the ICD-10 rollout at health insurer Wellpoint.
The Centers for Medicare & Medicaid Services (CMS) has selected defense contractor Northrop Grumman to develop and implement a fraud prevention system to help identify high-risk claims in support of the National Fraud Prevention Program.