‘Gold Card’ Approach to Prior Authorization No Hurdle for HealthEdge
States have been passing legislation in recent years to address the complaints of providers that they are subject to too many prior authorization requirements …
A successful implementation of our products begins with a strong foundational relationship between our health plan customers and HealthEdge. Our goal is for cu…
Trends of 2022: Business Process as a Service (BpaaS)
An Intro to Business Process as a Service (BpaaS)
BpaaS is the delivery of business process outsourcing (BPO) services as a cloud-based subscription service…
Impacts of COVID-19 on Care Management in the Dual-Eligible Population
COVID-19 has highlighted weaknesses in our healthcare system and shone a spotlight on fault lines, especially for the most clinically and socially vulnerable l…
Why Using Modern Technology is Critical to Serving the D-SNP Population
As the dual eligible population grows, Dual Eligible Special Needs Plans (D-SNPs) are also experiencing tremendous growth across the country. CMS reports that …
Within Medicare Advantage (MA), there are Special Needs Plans (SNP) with specialty cohorts that provide coverage for members who qualify for both Medicare and …
Public Health Emergency Clock Ticks Forward to July
As expected, the Biden administration extended the mid-April expiration of the Public Health Emergency (PHE) another 90 days, so the countdown again restarts f…
In the ongoing struggle to achieve clarity around how Surprise Billing regulations will work, the Centers for Medicare and Medicaid (CMS) opened a Federal IDR …
Skip to main content
