Nalashaa Healthcare Blogs
The proposed rule is currently titled ‘Reducing provider and patient burden’. However, the proposed rules do not promise any reduction of burden for payers. Payers must make sure their systems…
read more
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 it. The implementation approach will depend on various technological factors such as cloud platforms,…
read more
As the dates set for public disclosure requirements, Jan of 2022, draws close with every passing day, it is best for everyone involved if health plans got themselves aligned with…
read more
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 for both the Participants, Beneficiaries, or Enrollees, and the public.…
read more
It has been reiterated time and again by the CMS that member engagement is crucial to both the health plans and members. To the health plans, engaging with members contributes to their shared…
read more
The US healthcare industry is undergoing a tectonic shift towards Value-Based Care (VBC). Changing reimbursement models and HHS regulations are the two primary forces energizing the circumstances. Care providers are…
read more
The healthcare revenue ecosystem is always on the move to achieve operational excellence, to offer personalized policies, proactive care programs, and preventive healthcare measures of the best quality. One way…
read more
The healthcare industry is going through a makeover where organizations are pushed towards patient-centricity. With the rapidly surging volume of data and care information available online, regardless of the accuracy,…
read more
Payer organizations deal with data, day in and day out. It is not enough that payers fulfill their roles in the healthcare revenue ecosystem through claim management, credentialing, code entry,…
read more
From member enrollment, eligibility checks, and provider network management to billing and collection, healthcare payers are involved in handling and reporting sensitive healthcare data. The healthcare payer process is drawn out and cumbersome, with human errors resulting in penalties and loss of revenue, and must be automated…
read more
In the previous section we discussed the technologies available to enhance a PHM solution, and how it helps the healthcare industry. Current PHM solutions aim to achieve PHM goals by…
read more
The data being made available through Blue Button 2.0 initiative provides opportunities to leverage this data for meaningful purposes. Depending on the motivation of the user of these systems, the purpose and approach may differ.
read more