FEATURED CONTENT

• Pre-Pay, Post-Pay, And Blended Payment Integrity: Prevention Worth The Cure

  9/25/2019

  Today’s payers are increasingly focusing on optimizing claims management as part of a continuous effort to maximize operational cost savings. In fact, according to Black Book research, fraud management is projected to be one of fastest-growing payer services in the global healthcare BPO services market, with 92 percent of users citing it as a source of BPO value. Diligent attention to prevalent payment integrity issues is the fundamental requirement to combat the massive cost of recouping the overpaid amount. As a practice, payers deploy post-pay, pre-pay, or an amalgamated audit approach to detect, investigate, and recover overpaid claims or prevent overpayment.

• What's Your Strategy When HIPAA-Protected Data Literally Flies Out the Window?

  9/21/2016

  User frustration with technology is one thing. But aggravations that turn into veritable threats to data security? Those tend to be a touch more serious. And safeguarding all the places sensitive data ends up gets seemingly more complex by the year, thanks to the bevy of laptops, phones, and tablets we employees need to get our work done (whether those are company-issued devices or not). By Cam Roberson, Director of the Reseller Channel, Beachhead Solutions

• The Need for Eldercare Technology

  6/1/2015

  Eldercare is not a particularly sexy branch of the healthcare world, but it’s increasingly becoming more important. The senior population in the U.S. is booming – census data shows that the 65-plus population will exceed 79 million in 2030. And as the senior population continues to grow, the health of seniors continues to decrease as compared to prior generations. All this begs the question: How can we handle caring for seniors in the U.S.? By Wolf Shlagman, founder and CEO, Care Angel

• AI: Adding New Intelligence And Speed To Diagnostics

  7/11/2018

  Greater access to data and faster cross-referencing of symptoms, via AI, provides more thorough, real-time, treatment insights.

• Put Away The Checkbook, It's Time To Pay The Doctor Online

  5/3/2018

  When was the last time you used a check to pay for anything? I can’t remember the last time I used a paper check. Was it five or 10 years ago? I’m not entirely sure. But one place checks are still in use is at your doctor’s office. And it has to stop. Really. What was once a convenient payment method is now antiquated and should be retired as digital payments have become ubiquitous and secure.

• Riding The Herd To Transformational Success

  12/1/2016

  There is an unpleasant truth that almost any CIO or senior insurance executive is loath to admit: at some point in the past he or she has been involved in a large and costly technology initiative that failed spectacularly. It’s especially difficult when the initiative is at the root of the company’s operations, as are many core systems transformation initiatives. Why does this happen? There are many reasons, but many fail as a result of the effects of a kind of herd mentality.