Payers & Providers

How Providers Grow Revenue Without Compromising Patient Outcomes

When it comes to providing and receiving healthcare in the United States, cost means everything. Providers, payers, and patients are all motivated by price. Some claim it’s a good system, others say otherwise, but until a replacement arrives, it’s the only one available. With this in mind, providers need to find ways to grow revenue

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How Does Outsourcing Payment Posting Services Add Profitability to Your Medical Business?

The success of a healthcare business depends on the complete set of multiple tasks including patient care and medical billing.  Payment posting is the final but most crucial step in the billing process. A slight error in this process can put your entire revenue cycle at risk. This task cannot be performed easily by just

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HIPAA Privacy Rule Waiver and What it Means for Health Providers

The COVID-19 pandemic caused many changes in our society and the policies. U.S. healthcare system had to adapt to the new reality by restructuring several aspects of its operation, including the nation’s most crucial health privacy law, the Health Insurance Portability and Accountability Act (HIPAA). HIPAA was designed back in 1996 to improve the nation’s

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The Evolution of Provider-Led Health Plans in 2020 and Beyond

In a pre-pandemic world, providers and payers were proceeding with their usual pace toward value-based reimbursements. With a steadily-growing patient volume and broad health insurance coverage options, providers had the option of implementing value-based payment models with any number of insurance companies. Over time, providers began to explore the benefits of integration and in some

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Health Care Reform – Why Are People So Worked Up?

Why did Americans work up for bringing health care reform? Statements like “Don’t touch my Medicare” indicate a poor understanding of America’s healthcare reform history. America is facing new challenges about medical care reform, and this system crisis has been reached to a dangerous level. Let’s take a look at how the healthcare system started

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Guide to Navigating Quality Reporting For Healthcare Providers

Transitioning and succeeding in value-based care (VBC) is increasingly becoming the focus of many providers. Despite initial reservations, many providers are becoming ardent supporters of VBC payment models and are often the catalysts for change in their organizations. Traditionally, most providers were compensated under fee-for-service (FFS) arrangements (i.e., they were paid for services rendered, not

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