Care management for D-SNP populations: The key to compliance and member satisfaction
Dual Eligible Special Needs Plans (D-SNP) are a special kind of Medicare Advantage Plan for people who qualify for both Medicare and Medicaid. This program tak…
As consumers of digital services in our daily lives, our expectations of personalized self-service experience have been set by the likes of Amazon, Netflix and…
What are the top features of optimal Medicaid payment technology?
Medicaid MCO claims management is complex and dynamic. The traditional approach to Medicaid payment policies and fee schedules is challenged by the increasing …
6 Ways Technology Can Lighten Your Medicaid MCO Team’s Workload
According to the Kaiser Family Foundation, there are over 280 Medicaid Managed Care Organizations (MCOs) that provide comprehensive managed care for over 55 mi…
7 Most Common Medicaid MCO Claims Management Risks
“Variability in Medicaid is the rule rather than the exception. States establish their own eligibility standards, benefit packages, provider payment policies, …
Through value-based care arrangements, health insurance companies have the opportunity to share the burden of care delivery costs and rewards of high-quality c…
Opportunity is the Name of the Game in Today’s Health Insurance Market
As the 2022 open enrollment period comes to a close, health insurance industry leaders are facing a year of unprecedented change. For some, these changes are b…
The Digital Transformation Journey: Real-Time All of the Time
Batch processing of data has been the norm in the health insurance industry for decades. However, as the complexities and competition within the industry heat …
Health plans have historically struggled with high operational costs, often driven by a combination of complex business processes and manual-intensive workflow…
New Year Brings Milestone Regulatory Changes To Payers, Providers, Members
Change is right around the corner for payers, providers and health plan members that affect cost-sharing and provider network directories.
One of the most c…
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