Financial/Revenue Cycle Management

With the CopernicusMD platform, physician groups and others can assess a patient’s carrier eligibility and carrier pre-approval for procedures, bringing patients and payers together within the platform.

The technology's implications for interoperability, privacy, claims processing and more are intriguing. But many challenges must be addressed before wider applications become possible.

BCBS Louisiana rolling out a portal to provide immediate responses to authorization requests.

Pierre Yong and Monica Kay explain how to handle payment reform under the Medicare Access and CHIP Reauthorization Act and the law’s mandate to rid Medicare cards of Social Security numbers.

The vendor partnered with the National Decision Support Company to create what it claims is the first software that extracts clinical data from EHRs to streamline medical reviews and prior authorizations. 

Providers will need to identify ways to cut cost and payers need to be part of the solution.

The provider of MRI services went all-in on the approach, and it’s changed their business.

LHQF and UnitedHealthcare Community Plan of Louisiana created an HIE registry to keep patients out of the emergency room. 

Cathy Ball, who spearheads Lahey’s participation in the CMMI program, said bundled payments are a step in the right direction toward value-based care. 

A new health plan data exchange service from athenahealth offers support its providers who exchange clinical data with payers for quality management, risk adjustment and performance management programs, the company announced Wednesday.