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Improve Your Claim Denials

Two major priorities healthcare providers are constantly focusing on is improving revenue and boosting efficiency, in addition to improving prior authorizations and eligibility. However, providers may overlook the advantages of leveraging data to improve denials management. With a bit of denial management auditing, it may result in better financial outcomes. In many cases, providers have […]

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Essential Payer Contract Terms to Be Aware Of

One of, if not the primary goal of a provider is to ensure the health of their patient. However, often the payer contracts contain confounding provisions or legal terminology that may affect patient outcome improvements. These contracts typically describe a provider’s reimbursement arrangement for delivering healthcare services to patients that have coverage based on certain […]

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HIPAA Violation Prosecution and Health Care Providers

As the federal government zeroes in on fraud in the healthcare sector, health care providers should be aware that the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA) is rising as a source of criminal liability. This rule establishes uniform national standards to protect the medical records and personal health information of […]

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