The new CMS mandate for Electronic Prior Authorization (ePA) requests focuses on the NCPDP SCRIPT version 2017071 standard for four…
Author: Leo Roy
Here’s How You Can Implement Transparency in Coverage
In the previous blogs, we have defined the Transparency of Coverage rule’s compliance requirements and their corresponding solutions. Now that the expectations from the solution is set, here we are looking at the implementation. Let’s cut straight to…
Complying with Public Disclosure Requirements
As the dates set for public disclosure requirements, Jan of 2022, draws close with every passing day, it is best…
Solutions for Transparency in Coverage
The Department’s guidelines on ensuring transparency in coverage are quite elaborate on the context and objective of disclosing information. Our previous blogs outline the disclosure requirements…
Uncovering The Drawbacks Hampering Transparency In Coverage
Access to healthcare is undoubtedly one of the most important factors in leading a well-rounded, healthy life. Although access alone…
Must-share Details with the Public for Improved Transparency
The healthcare industry is witnessing a cultural shift, and aligning business goals along member-centricity. This shift is propelled by both member expectations as…
Increased Transparency to Encourage Cost-effective Care Decisions
With the onset of consumerism in healthcare, health plans must be prepared to make adjustments or modifications to IT systems…
Understanding the Limitations of Inadequate Data
Today, data is everywhere and in many forms. The processing power to crunch huge amounts of data and get analytical…
The Steps to Success for Healthcare AI/ML Endeavors
When Deepmind’s AlphaGo defeated Lee Sedol, a top professional Go player, in the year 2016, deep learning (DL), a subset of machine learning (ML), became the buzz…
Establishing an Analytics Culture – An Overview of the Roadmap
Although at the beginning of the 21st century, many businesses had started to focus on data, the COVID–19 pandemic has forced organizations to develop and adapt to a must–have data-driven culture at all levels.…
Descriptive Analytics: Baby steps towards Artificial Intelligence/Machine Learning
We are witnessing a rise in the use of AI/ML concepts and technologies in healthcare. Today, algorithms are already outperforming…
Integrating Claims and Clinical Data – An Essential for 2020
The health of your organization is directly dependent on the health of the members enrolled with it. A holistic view…