Claims Processing

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.

November 3, 2014 | Anthony Brino

All HIPAA-covered health organizations, and especially insurers, have been handed a small victory in the war of administrative simplification, as federal regulators once again back off a policy change long in the making.

October 29, 2014 | Anthony Brino

Figuring out when members are covered by different types of insurance can be a struggle, or not even possible. It's a source of waste and confusion that some insurers are trying to root out.

October 28, 2014 | Anthony Brino

The raison d'etre and central function of health insurers has had a slow time coming into the 21st century. But with both providers and patients demanding a better experience, the impetus for progress could bring a critical mass.

June 13, 2014 | Eric Wicklund

Amid the shift to high-deductible health plans, patients are finally getting more convenient options to pay for their health services up front.

May 29, 2014 | Bernie Monegain

The annual PayerView Report, from health IT company athenahealth, reveals the healthcare payer that has the best relationship with providers and the one that has the most problems.

May 27, 2014 | Anthony Brino

The federal government and a number of hospitals may want to transition to a new Medicare reimbursement model. But there are still billions of dollars in disputed fee-for-service claims waiting to be settled.

May 12, 2014 | Anthony Brino

Their rates may be somewhat low, but Blues plans tend to pay on time and can be trusted, a survey of health system executives found. Not so for other large insurers.

April 25, 2014 | Anthony Brino

Not-for-profit hospitals are facing huge revenue challenges amid payment reform and shifting payer mixes, leaving relationships with commercial insurers in a flux.

April 16, 2014 | Anthony Brino

Even with some 15 million Americans covered by high-deductible health plans, health organizations are "not prepared to meet consumer payment expectations," according to the fourth annual payment trends report by InstaMed, a Philadelphia-based payment network company.

April 7, 2014 | Anthony Brino

With about seven percent of all public and private health insurance claims paid incorrectly, insurers have a ways to go, beyond traditional models, if the healthcare spending crisis is to be reined in.

Advertisement. Closing in 15 seconds.