Insurance Premium Billing

Last year, we wrote about the transparency in coverage rule issued by the Centers for Medicare and Medicaid Services (CMS). CMS required most health plans to release machine-readable files of [...]

With Medicare Advantage’s annual enrollment period in full swing, many health plans are likely learning about the effectiveness of their 2023 Medicare Advantage growth strategies. A lack of [...]

Where COVID dominated headlines in 2020 and 2021, inflation has been omnipresent in 2022. Which begs the question: Has inflation impacted health insurance premiums in 2023 in the Affordable Care [...]

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published their Medicare Advantage Star Ratings for 2023 plans. Here’s a breakdown of the Medicare Advantage Star [...]

Medicare Advantage enables eligible beneficiaries to access Medicare benefits through a private sector health insurer. It’s seen consistent growth in the past decade and should surpass [...]

In August of 2022, Wisconsin’s Office of the Commissioner of Insurance (OCI) released a market analysis conducted by BerryDunn of the state’s individual health insurance marketplace. [...]

ACA Expansion Back in 2017, the Affordable Care Act (ACA) exchange marketplace seemed to be dying. Insurers were leaving state marketplaces – as many as 20% of enrollees only had access to [...]

Calculating Medicaid capitation payments can be a complex process incorporating several factors. Age, health conditions, geography, provider network, gender, and more can play a role in [...]

Last year, an advertisement featuring NFL legend Joe Namath gained attention in Medicare Advantage circles because of some potentially misleading claims. Though the Centers for Medicare and [...]

It’s likely that if you visit a health insurer’s website, it features happy, smiling members. Most insurers focus on delivering a great member experience to attract and retain [...]