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Understanding the Complexity of Healthcare Claims, Payments
While the healthcare industry has made significant strides in improving care quality and delivery, its approach to submitting and paying claims is wrought with complexity, inefficiency, and...Change Healthcare May Sell Assets to Prepare for UHG Merger
Change Healthcare is considering selling its payment integrity business, ClaimsXten, to prepare for its upcoming merger with UnitedHealth Group. ClaimsXten is a payment solution that aims to help...Sponsored Article
5 Reasons Why Payers Should Bolster Payment Integrity
Payers can elevate their payment integrity strategy to do much more than fraud, waste, and abuse prevention. A comprehensive payment integrity strategy is key to lowering costs and achieving higher...Medicare Coverage Policies Can Result in Millions of Denied Claims
The share of denied claims in Medicare is largely attributable to laboratories, according to a study published in Health Affairs. Researchers worked with Aetna and Medicare data to assess the number...Sponsored Article
As High-Dollar Claims Come In, Focus on Payment Integrity Is Key
Overall healthcare spending is slated to increase exponentially over the course of the next few years, and private payers are expected to foot a large portion of the bill. The Office of the Actuary at...Sponsored Article
How Pre-Payment Review Elevates Payer Payment Integrity
Payer payment integrity strategies are generally built around post-payment reviews to ensure appropriate reimbursement was sent to providers for medically necessary services. However, truly...Sponsored Article
Claims Payment Transformation Benefits Payer, Providers, and Members
Payers, providers, and members are all central to the healthcare experience, working together to create a seamless, coordinated encounter from registration and the clinical visit to claims payment and...Sponsored Article
Modernizing Claims Payment to Improve Member Experience
Paper checks and other forms of manual claim payments not only create friction between payers and providers, but also with the one stakeholder at the center of the whole experience: the member. Member...Sponsored Article
