Health Rules For Healthcare Payers
Listing Websites about Health Rules For Healthcare Payers
Auto-Adjudication Feature HealthRules Payer
(Just Now) WEBThat’s why HealthRules Payer has been ranked number one in its class among core administration platform solutions. Besides delivering 90%–97% first-pass auto-adjudication rates and 99%+ accuracy, it enables you to react swiftly to the latest regulatory shifts …
https://healthedge.com/solutions/core-administrative-processing-systems/healthrules-payer/
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Payer trends health systems should watch closely in 2024
(7 days ago) WEBAccording to data from the National Association of Insurance Commissioners, health insurers’ profit margins fell to 3.3% in the second quarter of …
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CMS Finalizes Rule to Expand Access to Health Information and …
(8 days ago) WEBThe rule also requires impacted payers to implement a Health Level 7 (HL7®) Fast Healthcare Interoperability Resources (FHIR®) Prior Authorization …
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How 3 Policies are Changing the Healthcare Payer …
(4 days ago) WEBThe Price Transparency Rule, No Surprises Act, and Access to Health Information Rule are forcing healthcare payers to change their strategies and adopt new technology, found Insights by …
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Key Regulations and Policies That Will Impact Payers in 2024
(5 days ago) WEBMedicare Part B premiums are based on beneficiaries’ incomes, but most will pay $174.70 per month in 2024. The annual deductible will be $240, up from $226 in …
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What the Prior Authorization Proposed Rule Means for Payers
(Just Now) WEBFebruary 24, 2023 - The CMS Advancing Interoperability and Improving Prior Authorization Processes proposed rule introduces new requirements for healthcare payers that aim …
https://healthpayerintelligence.com/news/what-the-prior-authorization-proposed-rule-means-for-payers
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Impact of HealthRules Payer on Healthcare Payer Operations
(3 days ago) WEBIt’s easy to say that something is efficient, but HealthRules Payer provides quantified proof: HealthRules software provides 90 percent to 97 percent first-pass auto …
https://healthtechresourcesinc.com/impact-of-healthrules-payer-on-healthcare-payer-operations
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Going Beyond Compliance: How Payers Can Embrace …
(3 days ago) WEBJune 28, 2021 - Payers may be prepared to comply with the interoperability rule for the July 1 deadline, but are they ready to adopt healthcare interoperability long-term?. For the past couple of
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What payer-led managed care models may look like McKinsey
(9 days ago) WEBCare delivery is an increasingly important part of payers’ enterprise and M&A strategy. Payer-led activity in care delivery has continued over the past five years. M&A, …
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HEALTH CARE PAYERS COVID-19 IMPACT ASSESSMENT: LESSONS …
(5 days ago) WEBIn contrast with other high-income countries, health care insurance and payment in the United States is highly fragmented. America’s multi-payer system spans …
https://www.ncbi.nlm.nih.gov/books/NBK589814/
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New CMS Rules Advancing Interoperability - Health IT Buzz
(2 days ago) WEBThe Centers for Medicare & Medicaid Services (CMS) proposed two important new rules in December 2022 which, if finalized, would advance electronic …
https://www.healthit.gov/buzz-blog/health-it-policy/new-cms-rules-advancing-interoperability
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The Payor Overview - Health Care Data
(5 days ago) WEBThe Payor Overview. Healthcare payors and delivery systems are facing disruptive changes as cost pressures are opening doorways to new business models. Healthcare …
https://healthcaredata.center/healthcare-delivery/the-payor-view/
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HHS Issues New Rule to Strengthen Nondiscrimination Protections …
(Just Now) WEBDownload the News Release Download the News Release - Word. Today, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) …
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The Role of Payers in Healthcare and Care Management
(Just Now) WEBPayers Role in Care Management. At its core, the payer’s role entails balancing cost and quality of care. Their day-to-day is managing the resources of a …
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Understand Regulatory Compliance for Health Plans in 2023
(5 days ago) WEBThe rating is a weighted average of a plan’s HEDIS® and CAHPS® measure ratings and accreditation status as of June 30, 2023. Furthermore, in 2023, HEDIS is …
https://healthedge.com/resources/blog/2023-regulatory-compliance-what-health-plans-need-to-know
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Medicare’s Coordination of Benefits
(7 days ago) WEBThis is called “coordination of benefits.”. If you have Medicare and other health or drug coverage, each type of coverage is called a “payer.”. When there’s more than one …
https://www.medicare.gov/publications/11546-Medicare-Coordination-of-Benefits-Getting-Started.pdf
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4 Regulatory Changes that will have a Big Impact on Payers in 2024
(4 days ago) WEB3. No Surprises Act. Introduced in 2021, the No Surprises Act was designed to protect consumers against surprise medical bills from out-of-network providers and …
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Final Prior Authorization Rules Look to Streamline the Process
(1 days ago) WEBFour APIs are included in the final rule (Table 1). The Patient Access, Provider Access, and Payer-to-Payer APIs facilitate exchange of claims and clinical …
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FTC Finalizes Changes to the Health Breach Notification Rule
(3 days ago) WEBMedia Contact. Juliana Gruenwald Henderson. Office of Public Affairs. 202-326-2924. The Federal Trade Commission today announced it has finalized changes to …
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How Payers Can Prepare for the Payer Price Transparency Rule
(1 days ago) WEBBy Kelsey Waddill. March 24, 2021 - Payers should prepare for the payer price transparency rule to go into effect by building clear communication paths with members, …
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Shifting the Payer Landscape with Health Tech - MedCity News
(8 days ago) WEBIt captures some of the ethical debates taking place in healthcare and looks ahead to how payers, providers and health tech companies are working together to …
https://medcitynews.com/2024/05/shifting-the-payer-landscape-with-health-tech/
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The Biden-Harris Administration Issues New Rule to Support …
(3 days ago) WEBProhibits the use or disclosure of PHI when it is sought to investigate or impose liability on individuals, health care providers, or others who seek, obtain, …
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CVS scoops up tech-enabled MA broker Hella Health
(2 days ago) WEBHella Health now lists on its website that it is "part of the CVS Health family of companies." (CVS) CVS has quietly acquired Hella Health, a startup Medicare …
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Alignment raises membership guidance but posts $47M net loss
(Just Now) WEBIts full-year membership range now sits at 170,000 to 172,000. Alignment reported total quarterly revenue of $628.6 million, a 43.1% year-over-year improvement. …
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Court says state health-care plans can’t exclude gender-affirming
(Just Now) WEB5 min. A federal appellate court in Richmond became the first in the country to rule that state health-care plans must pay for gender-affirming surgeries, a major win for …
https://www.washingtonpost.com/dc-md-va/2024/04/29/gender-affirming-surgery-state-health-care-plans/
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House health care bill aims to contain costs, set rules to prevent
(1 days ago) WEBOfficials in Mariano’s office pitched the wide-ranging bill as the biggest effort to contain health care costs since the 2012 law that established the Health Policy …
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Medicaid final rules improve care access for managed care, FFS
(6 days ago) WEBThe rules address payment rates, care quality, and home- and community-based services in Medicaid managed care and fee-for-service plans. April 23, 2024 - …
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How the NCAA is prioritizing mental health - NCAA.org
(3 days ago) WEBThe program includes coverage for mental health services stemming from an eligible, documented athletic injury sustained during participation in an NCAA qualifying …
https://www.ncaa.org/news/2024/5/1/media-center-how-the-ncaas-prioritizing-mental-health.aspx
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‘The next frontier of emergency medicine’: House calls following
(7 days ago) WEBThe Connected Care Center offers a range of services that includes Express Care, which provides on-demand video appointments, and Urgent Care at Home for …
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