denial management
publication date
Payer
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get to Leave, Too
In the past 15 months, CMS has quietly offered roughly three-month special enrollment periods allowing MA members in 13 states...
Payer
'They Won't Help Me': Sickest Patients Face Insurance Denials Despite Policy Fixes
Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
Payer
Deny and Delay? California Seeks Penalties for Insurers that Repeatedly Get It Wrong
Experts say it could be one of the boldest attempts in the nation to rein in health insurer denials, before...
Payer
Montana Looks To Regulate Prior Authorization as Patients, Providers Decry Obstacles to Care
Advocates say it's time Montana joined many other states in limiting how and when insurers can deny drugs or treatments...
Payer
Insurers Failed to Comply With Mental Health Coverage Law, Department of Labor Report Finds
The probe found widespread noncompliance and violations of federal law in how health plans and insurers cover mental health care,...
CFO
CFO In The Know: The MA Increase
Here's how CFOs are currently feeling about Medicare Advantage.
Revenue Cycle
The Winning Edge: Tackling the Denials Dilemma
Denials are a major pain point for revenue cycle leaders. Here?s how to manage?and perhaps even prevent?them.
The Data Dilemma: How It's Costing Health Systems Millions
The healthcare industry's data dilemma is costing health systems millions.
Revenue Cycle
Let's Get Digital: How 2 RCM Leaders Are Tapping Tech to Improve Patient Access
All eyes on prior authorization and scheduling.
Payer
Now What?
Is the murder of a healthcare executive enough to finally change our broken healthcare system?
Payer
UnitedHealth Is Strategically Limiting Access to Critical Treatment for Kids with Autism
Advocates says the insurer's strategy may be violating federal law.