Technology enhancements are transforming the healthcare landscape, but with these new improvements, health plans still face…
Category: News
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…
Case study: Prepay COB boosts payment integrity results for large national payer
The Host As he had wanted, President Donald Trump signed his big budget bill into a…
CCC25: 3 key pillars required to perform beyond healthcare challenges
As health plan leaders in quality improvement, risk adjustment, and payment integrity gathered for the Cotiviti…
Webinar: Reflecting on HEDIS MY 2024 and preparing for what’s next
The conclusion of another HEDIS® season offers health plans an important opportunity to evaluate their performance,…
Webinar: Billing and policy trends impacting your payment integrity program
While health plans seek to pay claims as accurately as possible, implementing new payment policies requires…
FWA Insights: Excessive dental restorations
As healthcare costs rise, dental costs have been no exception—recently increasing by $4 billion in a…
Webinar: Unlocking value from interoperability investments
As health plans continue to advance their digital transformation efforts, interoperability remains a critical driver for…