Information Blocking Rule: The changes for 2023
As we can see from the above infographic providers are facing the wrath of information-blocking claims. 6th October 2022, HSS released a revised version of the Information blocking rule to…
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Posts Tagged :
compliance
Telehealth Reimbursement Policy Reforms for 2023
What Does CMS Have to Say: 2023 Medicare Physician Fee Schedule In 2019, a terrible pandemic swept across the world. A pandemic that forced us to stay at home but…
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Patient Protection and Affordable Care Act – Benefits and Payment Parameters for 2023
The Patient Protection and Affordable Care Act, also known as Obamacare, signed into law on March 23, 2010 has had a series of rules and regulations published under its wing.…
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Utilize Data Analytics to Reduce Member Dropout
Member management is crucial to healthcare payer organizations. Member engagement KPIs are what decide a payer’s Net Promoter Score. This means that payers must put in extra effort to ensure…
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How Do Analytics Help Reduce Payer’s Burden?
Before we step into how data analytics can transform a payer’s organization for the better, one must address the chains holding them back from the miracles of analytics. The lack of…
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The Various Facets of FHIR
FHIR has taken the healthcare industry by storm. Health plans are rushing to incorporate FHIR into their systems to not just evade penalties but also to attain the end goal…
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The Genesis of FHIR
The need for interoperability was first highlighted back in the 1980s when payer organizations had to expand to working with data from more than one system. They needed a foolproof method of…
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Lost in Provider Management? Here Are a Few Ways Out
In the previous blogs, we’ve covered payment models and the processes involved in provider network management. However, in practical world scenarios, managing a provider network can be tedious and repetitive. In this blog, we shall…
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Here’s What You Need to Know About Provider Network Management
Having provider networks is a necessity. This is true for health plans and providers or hospitals, and especially, for the enrolled members. Managing provider networks can be a lot of work. Identifying the providers and hospitals according to the parameters mentioned in…
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Electronic Prior Authorization For Medicare Part D – The Essentials
The new CMS mandate for Electronic Prior Authorization (ePA) requests focuses on the NCPDP SCRIPT version 2017071 standard for four electronic Prior Authorization (ePA) transactions. The PA initiation request/response, PA…
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Expanding on Previous Rules to Improve Interoperability and Reduce Burden
Back in May 1, 2020, The Centers for Medicare & Medicaid Services (CMS) introduced the Interoperability and Patient Access Final Rule. The rule aimed to improve healthcare quality provided by…
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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 and business processes to include the oncoming set of rules…
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