Following a period of public comment on proposed changes earlier this year, the National Committee for…
Category: News
Perform Beyond Doubt: Turning uncertainty into informed action
Health plans face high-stakes decisions daily, often without full visibility into how those decisions will impact…
FWA Insights: Identifying a DME dropshipping scheme
Inappropriate billing for durable medical equipment (DME) continues to be among the most prevalent fraud, waste,…
Perform Beyond Hype: Going beyond buzzwords in healthcare
In a healthcare landscape saturated with promises of transformation through artificial intelligence and automation, payers are…
Decoding HEDIS® MY 2024 for success in MY 2025
Health plans are under increasing pressure to deliver measurable quality improvement while navigating regulatory shifts, operational…
Perform Beyond Silos: Uniting people, programs, and partners across healthcare
Healthcare’s most persistent challenge isn’t always technology—it’s fragmentation. With departments like quality improvement, risk adjustment, payment…
Webinar: Enhancing member engagement and communication
Technology enhancements are transforming the healthcare landscape, but with these new improvements, health plans still face…
Two key claim trends and their impact on payment integrity
Healthcare billing practices are constantly evolving, significantly impacting payment integrity for health plans seeking to prevent…
FWA Insights: Uncovering improper billing in urine drug screens
Improper billing practices and schemes related to urine drug screens (UDS) are common, requiring investigative resources…
Unlocking business value through interoperability: 3 key strategies
As healthcare organizations navigate the evolving digital landscape, interoperability has become more than a regulatory requirement—it’s…