Learn the steps that payers must take to comply with the CMS Interoperability and Prior Authorization rule, also known as CMS -0057-F.
What CMS-0057-F Means for Health Insurance Companies In January 2024, CMS finalized its interoperability and prior authorization rule that requires various healthcare insurance entities to...
Learn how providers automate prior authorization with Salesforce to reduce cost, improve efficiency, and achieve regulatory compliance.
Challenges of Manual Prior Authorization The big irony is that most healthcare facilities still utilize manual prior authorization in today’s digital climate. This process burdens...
Learn about the latest rendition of the OCR Bulletin, and what it means for healthcare companies using third-party trackers.
The ideal healthcare ecosystem is one where the patient thrives and the hospital functions at peak efficiency. However, this is only sometimes a reality, as...
Learn about the latest rendition of the OCR Bulletin, and what it means for healthcare companies using third-party trackers.
In this article, I'll interpret the updated guidance and describe what has changed – and what hasn't. The updated guidance covers three main points: Defining...
At its core, utilization management analyzes trends in healthcare service use. It determines if these services comply with best practices and clinical guidelines. Traditionally, Utilization management (UM) was viewed primarily as a cost-control measure rather than a tool for enhancing service quality.
The value-based care strategy requires connecting a patient's health ecosystem, which includes primary care, specialty clinics, and payers. Discrepancies in this ecosystem have a significant...
Patient privacy compliance is a moving target. Innovative technologies, changing tech standards, and a dynamic regulatory environment can make it challenging for healthcare providers to keep up-to-speed, especially those operating in multiple states or regions. In 2024, providers must ensure they comply.
Digital patient forms offer a superior solution for the healthcare sector, swiftly supplanting traditional paperwork. Here's why. Paper Forms are Inefficient Manually filling out, sorting,...