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: ...
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 ...
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 ...
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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