Ensuring adequate coverage across provider networks is a top priority for health plans that want to stay competitive and offer a positive member experience. But for patients to benefit from plan coverage, they first need access to accurate and transparent…
Author: Madilyn Billings
Payment fraud can seem like an existential threat to payers. The reality is that healthcare payments are a constant target for payment fraud, and payers drive many of the transactions that are the most valuable to fraudsters, including claim payments…
Provider payment is increasingly moving toward value-based reimbursement, for both public and private payers. Yet some providers remain leery about how it works, what it means for their organizations and what various options are.