2019 Final Rule for Therapists
Outcome of 2019 Final Rule for Therapists

The Centers for Medicare and Medicaid Services released the Final Rule of the 2019 Medicare physician fee schedule (MPFS). It mainly includes adding physical and occupational therapists as eligible clinicians for 2019 MIPS performance year.

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Pharmacy benefit managers
Pharmacy Benefit Managers and Prescription Drugs

Pharmacy Benefit Managers (PBMs) are professionals that administer prescription drug plans for payers, employers, and CMS programs with the goal of lowering prescription drug costs, improving convenience, and ensuring patient…

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UM technology
Optimizing Utilization Management with Technology

The technological capabilities have changed the shift from volume to value-based care. The combination of value-based delivery with actionable intelligence and new care delivery models, and value-based payment with new…

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Benefits of Utilization Management
Benefits of Utilization Management

Utilization Management is an integral part of the US healthcare ecosystem used by health insurers or Pharmacy Benefit Managers (PBMs) to evaluate the appropriateness, medical necessity, and efficiency of healthcare services…

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Opioid Crisis and Technology
A sketch on Opioid Crisis and Ways to Tackle

Headlines on opioid epidemic are engrossing the United States. There are tremendous impacts of opioid overdosage across the care continuum with no single solution. Impacts of Opioid Crisis The opioid…

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home health agency technology
How can Technology Help HHA Providers?

Areas where technology helps providers cope with the new changes Identity Management EMPI solution to detect duplicate records Duplicate records provide a splintered view of patient’s medical history, leading to…

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QHP review tools
Review Tools for QHP Application

The CMS provides issuers with a number of review tools to check their plans for errors in the QHP application that would result in correction notices following submission. Issuers should…

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Qualified Health Plan
QHP Certification Guidelines for Payers

The Patient Protection and Affordable Care Act (PPACA) and applicable regulations assert that health plans, including SADPs, must meet a number of standards in order to be certified as a…

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An Introduction to Qualified Health Plan

The Affordable Care Act (ACA), defines QHP as an insurance plan certified by the Health Insurance Marketplace which provides Essential Health Benefits (EHBs), follows established limits on cost-sharing, and meets other requirements…

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