Claims Processing

November 17, 2015 | Susan Morse

The news comes as more health plans move from broad networks and straightforward reimbursement approaches to narrow networks and value-based payments.

November 10, 2015 | Kaiser Health News

Though healthcare systems can gain insurance know-how by partnering with or acquiring an insurer or third party administrator to handle claims, compliance and customer service, putting it all together can be challenging.

September 4, 2015 | Susan Morse

Even when a natural disaster doesn't force a hospital to shut its doors, unexpected catastrophes can disrupt operations and finances.

August 25, 2015 | Susan Morse

MeriTalk report claims 11 percent of people who receive government healthcare benefits are not actually eligible.

August 14, 2015 | Kaiser Health News

One of the health law's key protections was to cap how much consumers can be required to pay out of pocket for medical care each year. Now some employers say the administration is unfairly changing the rules that determine how those limits are applied, and they're worried it will cost them more.

May 8, 2015 | Anthony Brino

While so much is changing, so much is still the same in healthcare, like the fact that some 85 percent of commercial health insurance payments are still paper-based.

May 4, 2015 | Anthony Brino

Amid record enrollment, some Medicare Advantage insurers are finding their payment-linked risk scoring practices to be the subject of scrutiny and lawsuits.

March 31, 2015 | Anthony Brino

Health insurers in New Jersey are complaining of a cost crisis arising from regulations meant to protect patients receiving emergency healthcare and involuntary out-of-network treatment.

March 3, 2015 | Anthony Brino

Health insurers treading in legacy business processes are turning to contractors for help ply the new waters of reform, fueling an $8 billion market of its own.

February 13, 2015 | Anthony Brino
After a weekend of Merlot, brie, oysters and chocolate (and maybe more snow), a sampling of the most prolific prose from an annual healthcare tradition: health policy valentines.

January 15, 2015 | Anthony Brino

A few months ago, North Carolina's largest insurer was hesitant to reveal hospital payments on a state-mandated consumer information website. Now, it's making a bigger leap with its own online transparency initiative.

January 13, 2015 | Anthony Brino

Advocates of a radical reform solution are pointing to new evidence of the burdens of private sector administrative bureaucracy.

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