Before we step into how data analytics can transform a payer’s organization for the better, one must address the chains…
Healthcare Compliances and regulations
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…
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…
Provider Network Management Challenges and Solutions
Managing a provider network can be a time-consuming and repetitive task because government regulations are constantly changing. Furthermore, each organization…
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…
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…
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…
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…
The CXO Toolkit: Areas of Focus in Healthcare Technology Development in 2021
Since the Meaningful Use initiatives of 2009, Healthcare Information Technology (HIT) development has been driven by continually evolving healthcare regulations. The…
Patient Safety Reporting & Healthcare Payouts
March 8 – 14 was the patient safety awareness week, and as we at Nalashaa look deeper into our goal…
QOPI – Aiming to assess and improve cancer care
Quality Oncology Practice Initiative (QOPI) is a program by the American Society of Clinical Oncology (ASCO) exclusively for outpatient chemotherapy…
PQRS Claim-based Reporting
As discussed in previous post, PQRS reporting can be done using various methods: Claims-based Registry-based Qualified Electronic Health Record (EHR)…