Claims Processing
Progress toward ICD-10 implementation is revving up, according to a survey commissioned by the TriZetto Group, a provider of healthcare IT software and service solutions.
As providers keep hearing over and over-from RACs and their own Medicare contractors, insufficient documentation is frequently the reason for claim denials.
Two healthcare IT companies are joining forces to market an Internet-based personal health record solution to insurance providers looking to cut unnecessary clinical and administrative costs.
Two Florida based healthcare IT companies, one focusing on practice management and the other on electronic medical records, are partnering to help urgent care centers and hospital emergency departments manage their clinical and administrative affairs on one platform.
Business intelligence may sound “techie,” but it really isn’t.
The developer of a national over-the-counter healthcare benefits payment platform now being used for Medicare Advantage members has unveiled a new platform for Medicaid, giving the beleaguered state-run program a means of controlling costs and cutting waste.
More than 60 percent of self-insured employers in the United States are expected to offer a consumer-driven healthcare plan this year. Many of them – and their employees – will need to know how to “shop” for healthcare services.
The Centers for Medicare & Medicaid Services (CMS) today issued a proposed rule that would increase Medicare payment rates under the IRF Prospective Payment System (PPS) by a projected 1.5 percent in fiscal year 2012 - an estimated $120 million nationwide.
Florida Gov. Rick Scott’s controversial plan to privatize Florida’s Medicaid and CHIP programs covering 2.9 million people continued to move through the Florida legislature last month, though a May 6 end to the current session will leave the House and Senate a short window to reconcile the two versions of the bill.
The California Department of Managed Health Care has asked Blue Shield of California to justify a 37.5 percent increase for approximately 70,000 members who are in managed care plans.