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…
healthcare services

Watch Out for these Anchors Holding you Back from Compliance
The proposed rule is currently titled ‘Reducing provider and patient burden’. However, the proposed rules do not promise any reduction…

The Healthcare Interoperability Roadmap for 2021
The COVID-19 pandemic is still at large, operating in waves and through transmutation. It appears that its effects are destined…

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…

The Essential Touchpoints for Care Providers in Preventive Care in 2021
The outbreak of the COVID-19 pandemic presented a unique challenge for care providers. They were handed the daunting task of…

Healthcare Data: The Treasure Trove of Success for Healthcare IT Developers
The healthcare industry is currently undergoing a tectonic shift towards a patient-centric care model to pursue Value-Based Care (VBC). To…

Exploring the Opportunities to Reduce Cost In Healthcare Operations
Cost is one of the key elements that profoundly influences the efficiency of care delivery operations. Care providers don’t just…

The Future of HIT Development: The Top Touchpoints for HIT Developers in Patient Engagement
Patient engagement was initially only a methodology to ramp up the extent of patient satisfaction. With the improvement of healthcare technology, many…

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…

Meandering Through Member Engagement: Save Yourselves a Setback
It has been reiterated time and again by the CMS that member engagement is crucial to both the health plans and members. To…

Driving Member Engagement: A Closer look at Member Journey
Health Plans are in pursuit of ensuring that members get to choose the best healthcare service which results in better care quality and outcomes. To do so, they are expected to come up…

Engage Your Members. It’s Now or Never.
Member engagement is the new trend, taking the healthcare ecosystem by storm. Health Plans are now compelled to make themselves more…