For many physician practices -- especially those working with health maintenance organizations (HMOs) -- obtaining pre-authorization to perform certain treatments or procedures is a necessary evil: ...
Delaware Insurance Commissioner Karen Weldin Stewart has fined Blue Cross Blue Shield of Delaware $325,000 due to deficiencies in the health insurer’s nuclear cardiac imaging testing pre-authorization ...
Few hospitals would admit to not having a denials management program, yet one in five claims for services already rendered is denied or delayed. 1 Denials erode the provider organization’s bottom line ...
SEVEN NEWS. IN OUR HEALTHBEAT. TODAY, DOZENS OF HEALTH INSURANCE COMPANIES ARE COMMITTING TO MAKING IT EASIER FOR PATIENTS TO GET APPROPRIATE CARE. A NEW REPORT SAYS SEVERAL INSURERS WILL SIMPLIFY THE ...
DECISION, AND IT’S EASIER THAN YOU MIGHT THINK. IN 2023, NEARLY 1 IN 5 IN-NETWORK HEALTH INSURANCE CLAIMS FROM PLANS SOLD ON HEALTHCARE.GOV WERE DENIED. AND IT WAS EVEN WORSE FOR OUT-OF-NETWORK CLAIMS ...
Most organizations take an administrative approach to managing denials. Maybe that’s why they’re not collecting as much as they should. Few hospitals would admit to not having a denials management ...
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