Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Claims Management News

Risk-Stratified Care Management Enables Customized Treatment

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Among health payers, one necessary strategy aimed at ensuring superior patient health outcomes is based on risk stratification and the data analytics behind this process. The American Academy of American Physicians defines risk-stratified...

Claims Processing Found Successful after ICD-10 Transition

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Now that the ICD-10 transition has taken place across the country over the last month, the number of diagnosis codes has grown tremendously and many are wondering whether healthcare providers and payers will be able to successfully file...

CMS Reports Few Claim Rejections with ICD-10 Coding System

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On October 1 of this year, healthcare organizations including payers and providers around the nation switched over from ICD-9 coding to the new ICD-10 version for diagnostic coding. Along with affecting direct patient care, the ICD-10...

How Providers can View Claim Status after ICD-10 Transition

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With hospitals, clinics, and health insurers moving fully into the ICD-10 transition over the last several weeks, it becomes imperative for providers and payers to determine whether their systems are working properly and reimbursement is...

State Workers’ Health Insurance Claims at Risk in Illinois

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Currently, there is a healthcare coverage crisis taking place for state employees in Illinois. CBS reports that the state of Illinois is having major complications related to keeping its budget intact. The state budget issues are impacting...

How the ICD-10 Transition Deadline Changed the Nursing Role

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The October 1st ICD-10 transition deadline has passed and the healthcare industry still seems to be holding steady. However, only time will tell whether healthcare payers and providers were truly ready for the move to the...

More Time for Patient Care with Concierge Model of Medicine

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There are a wide variety of different payment models being implemented across the healthcare industry. Providers and payers are deciding which will provide the best quality of care while, at the same time, lowering costs. From...

Will the Move to ICD-10 Medical Coding Delay Claims Processing?

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The health insurance space is about to have a major transformation in medical coding that could potentially cause financial barriers and claims processing issues. If the transition to ICD-10 medical coding is not properly managed, a...

ICD-10 Implementation Deadline Affects Claims Processing

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Healthcare payers have a wide variety of concerns with regard to the coming ICD-10 implementation deadline and will need to be prepared for any potential issues that may pop up after the October 1, 2015 deadline. With a mere six days left,...

3 ICD-10 Implementation Concentrations for Healthcare Payers

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As healthcare payers adjust their business models to more cleanly align with the continuously evolving ICD-10 landscape, immediate concern is being placed upon where payers should be focusing next as the healthcare...

Insurance Coverage Grows as Consumers Explore Payer Options

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Attitudes toward healthcare coverage and healthcare reform have been reshaped in recent years. New avenues of healthcare coverage have come to light, and they are opening more options for how consumers may receive their coverage. Between...

3 Questions to Ask When Processing Medical Billing Claims

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Claims management – the art of consolidating, billing, filing, revising, and managing medical claims – is an imperative aspect of the healthcare industry. Medical facilities cannot receive due funds if patients are unaware or...

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