Turn to Technology to Reduce Your Compliance Risks and Increase Employee Satisfaction As a healthcare payer, you work hard to process claims, manage appeals and grievances, and satisfy your members. But, despite your best compliance efforts, the risk of an…
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Healthcare payers often face challenges as they work to speed up processes, improve member satisfaction and minimize compliance risks. A recent study found that more than half of payers (53%) ranked “improving data efficiencies” as a top priority. Additionally, over…
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You have big plans to grow your healthcare payer business. Before you start planning your future, take stock of your present operations. If the fundamental ways your organization gets work done are less than optimized, meeting those goals – and…
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Appointment of Representative, (aka the AOR) always seems to be a topic of conversation in the healthcare payer space. Every show we attend, every customer we talk with and every industry function we attend, there are intense conversations and differing…
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As part of an initiative to streamline the Medicare Advantage and Prescription Drug appeals and grievance processes, CMS has consolidated Chapter 13 of the Medicare Managed Care Manual and Chapter 18 of the Prescription Drug Benefit Manual into one comprehensive…
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Does your contracting process take forever? Can it take weeks, even months to bring a contract from creation, through negotiation and finally to execution? What causes the bottlenecks and how can they be fixed? First, let’s identify some common hurdles…
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There is no way to sugar coat it – Medicare Advantage plans are not meeting their customer satisfaction goals. Surveys prove it, with satisfaction having dropped from 2017 to 2018. One of the main drivers for the discouraging results is…
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Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What…
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Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What…
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Imagine if each time you entered an address into your GPS you only had a 50% shot that you would arrive at your correct location. You would be pretty upset if you weren’t in the 50% that made it to…
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