Healthcare Payers

Healthcare Payers

Can Technology Fix the Prior Authorization Challenge for Payers?

Bottom line upfront:Health plans developed prior authorizations (PA)s with noble goals in mind. And research shows PAs have achieved one of these goals: lowering drug costs. But the process has gotten out of control and become a growing burden for providers, payers, and members. The good news is, the right tech can solve prior authorization […]

Health Event Notifications, Healthcare Payers

Industry Commentary: 4 Ways ADT Event Notifications Improve Payer Performance

The new CMS Rule for admission, discharge, and transfer (ADT) notification for Conditions of Participation (CoPs) requirements and shared risk arrangements officially went into effect on May 1, 2021. This rule was enacted to improve coordination of care between hospitals and the post-acute provider teams, both streamlining and enhancing communication. It is these provider teams […]

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