payers

From the denials to critical updates on 340B and prior authorization, here is a look back at the trends and...

For select conditions, Aetna is introducing processes for authorizations that integrate pharmacy prescriptions and medical procedures into a single clinical...

See how this pediatric CFO strategically balances a Medicaid-heavy health system through regulatory uncertainty.

A new KFF analysis reveals that retrospective chart reviews are a primary driver of risk-adjusted payments for Medicare Advantage insurers,...

St. Christopher's Hospital for Children CFO Edward Bleacher explains how communication, payer strategy, market vigilance, and disciplined capital management define...

Stephen Rinaldi, Chief Revenue Officer at UNC Health, argues that revenue cycle leaders should take advantage of AI- enabled analytics...

The American Medical Association?s new minimum standards for rural-focused alternative payment models aim to counteract widespread financial losses and service...

"We're trying to create ecosystem solutions and not point solutions," says Longitude Health CEO Vishal Agrawal.

Several payers are accusing providers of driving higher healthcare costs through aggressive coding practices.

Almost 4 in 10 disputes submitted to the IDR process are deemed ineligible by insurers.

Insurers report that nearly 40% of payment disputes filed under the No Surprises Act's independent dispute resolution (IDR) process are...

The integrated health system has a grand vision to use conversational AI as an 'added member of the care team'...