Understanding the Intent Behind the No Surprises Act
We have an Interim Final Rule for the No Surprises Act, referred to as Part I. The comment period closed on September 7, 2021.
This is the administrative pi…
People, Process, Technology—A Cliché That Still Rings True
With a track record of selling core/claims administration technology to health plans for more than 30 years, I’ve heard all the reasons as to why health plans …
Tri Agencies published a Frequently Asked Questions (FAQ) document on August 20, 2021, addressing the Transparency in Coverage (TiC) Machine-Readable Files (MF…
Value-Based Reimbursement: Collaboration Required to Lower Costs and Improve Care
Our recent consumer survey showed that 47% of the 3,000 respondents postponed care. And of that 47%, 55% delayed routine visits, 39% elective treatment, 32% es…
Claims adjudication is one of the most crucial elements to a core administration processing solution, and its success depends on automation and accuracy. Learn…
Breaking Down Silos for Improved Member Experience
EHRs, mobile devices, wearables, claims data, and population health analytics can provide enough healthcare insight to improve outcomes at lower costs. But as …
Why Medicare Advantage Plans Have the Most Satisfied Members
While it may not have been a completely shocking revelation, I was excited to see one of the results of our recent survey of 3,000 consumers indicating that Me…
John Kao is a seasoned entrepreneur and executive. After beginning his career at FHP International, he then started four other companies in succession: Secure …
Finding New Ways to Deliver Care, While Controlling Costs
Existing fee-for-service payment models are not scalable. Across the industry, there is an increasing emphasis on finding ways to deliver quality care while co…
Looking for an Internship? Three Steps You Can Take to Stand Out
People can work remotely from nearly anywhere in the world today, creating a broad market for internships and giving businesses a large, diverse pool of young …
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