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Opportunities, Collaboration and Innovation in 2021
The biggest issue facing payers today is that their business changes every year. The pressure to develop reimbursement methodologies with providers that accoun…
Healthcare is an Industry of Change, Are You Prepared?
Many people have said that there has been more change now than ever before within the healthcare industry. However, if one reviews history, healthcare has been…
How Health Plans Capture New Business in a Competitive Landscape
Successful health plans are focused on expanding membership, increasing revenues, and controlling administrative costs. However, administration costs attributa…
Patient or Member? How About Calling Them Customers?
What are individuals called in a health plan? Members. What are people called when they meet with a provider? Patients. What is an individual person referred t…
I joined HealthEdge seven years ago when, like most startup organizations, we were primarily focused on our mission, products, and exciting our customer base. …
A Possible Survival Guide for Regional Health Plan Expansion?
Regional health plans have generally flourished in the respective local markets that they have served. However, regional health plans only “extended” as far as…
Health plans with legacy systems, disjointed workflows, and paper-based anything struggled to handle the sheer volume and veracity of new care and pa…
Changes to the health insurance industry have been traditionally very slow. However, the global pandemic has forced health plans to move forward with decisions…
Three Tips For Building Technology Training Programs
Earlier in my career, I handled implementations for a software vendor and noticed a common occurrence among customers that is still prevalent today. The first …
Regulatory Highlights that Health Plans Should Know
The Patient Access API and the Provider Directory API will be enforceable on July 1, 2021. HealthEdge is confident that we will have our standardized data requ…
Imagine an expectant mother has high blood pressure and sees a specialist. After the visit, the provider submits the claim to her insurance plan, and from ther…
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