Insurance Premium Billing

In recent years, there have been significant advancements in how health insurance companies deliver services to their members. Innovations like digital platforms and personalized guidance have [...]

After years of being a highly profitable market for health insurers, the regulatory sands may be shifting for Medicare Advantage payers. Star ratings have tightened up, with the average rating [...]

Advances in technology, aging technology infrastructure, shifting regulations, and increasing competition have made it difficult for payer CIOs to prioritize activities. Here are 5 key actions [...]

In August, the Centers for Medicare and Medicaid Services (CMS) published draft guidance regarding a new payment plan option for Medicare Advantage Part D beneficiaries called the Medicare [...]

In a world where the potential of artificial intelligence (AI) looms large, it’s easy to envision a future where its capabilities may seem limitless, even posing existential threats – [...]

According to recent data from Zippia, companies lose 18% of their workforce each year, with 12% of this turnover being voluntary. Even worse, in the finance and insurance industry, that number [...]

Last week we examined the New Mexico Medicaid buy-in legislation that sanctioned the study of a new Medicaid buy-in for state residents.  Minnesota passed similar legislation this session, SF [...]

On March 16, 2023, New Mexico Governor Michelle Lujan Grisham signed House Bill 400. Though the initial house bill authorized a Medicaid buy-in program in the state, named Medicaid Forward, the [...]

According to data analyzed by the Commonwealth Fund, 17% of beneficiaries voluntarily disenrolled from a Medicare Advantage plan in 2021, an increase of 7% from 2017. For health plans, those [...]

Inaccurate billing practices can negatively impact a health plan’s brand and bottom line. Plus, correcting those mistakes wastes time and inflates call center call volume. Ensuring accurate [...]