There’s widespread gaps in Medicare knowledge among both current beneficiaries and adults approaching eligibility for the program, even as most enrollees express high confidence in their understanding of the program, according to a new eHealth survey. The findings, released Aug.…
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Humana tapped Shantanu Nundy, MD, to serve as the company’s chief medical officer, effective Aug. 31. According to an Aug. 20 news release, Dr. Nundy will inform the company’s AI use, products and platforms. He will report to Humana President…
Commonwealth Care Alliance has named Pablo Hernandez, MD, as vice president and chief medical officer. Dr. Hernandez’s career has focused on healthcare for individuals who are dually eligible for Medicare and Medicaid, according to an Aug. 11 news release. Most…
New York City-based Mount Sinai Health System is no longer accepting some new patients with government-backed health coverage, according to since-removed notices on its website. An archived webpage shows how Mount Sinai stopped accepting new patients with Centene’s Fidelis Care Medicaid, exchange…
The average end-of-year balances for health savings accounts reached $5,532 in 2024, up from $4,747 the year prior. However, that balance fell far below out-of-pocket maximums. In 2025, out-of-pocket maximums for HSA-eligible health plans were $8,300 for individual coverage and…
by: LocumTenens.com Mergers, physician group exits and service line changes rarely arrive with a convenient pause. Schedules still need filling. Quality and safety metrics still need to hold. And whoever owns clinical staffing suddenly faces a problem that looks nothing…
Presented by:
Most revenue cycle teams are not underperforming because people are not trying. They are underperforming because the work is scattered. Every added vendor creates another handoff. Every handoff creates a place where accountability goes soft and a claim can sit.…
Nov 16, 2026 1:00 PM - 2:00 PM CST
Presented by:
Presenters:
- Alicia Johnson, Associate VP of Revenue Cycle, Lake Regional Health System
- Nicole Rogas, President, RevSpring
Why Your Solution for Electronic Prior Authorization Should Support Adaptable Questionnaires
Sponsored
HL7® FHIR®, the modern data exchange framework powering US healthcare’s move to electronic prior authorization (ePA), offers two digital approaches for specifying documentation needed for prior authorization: standard and adaptive questionnaires. Other technical considerations that must be addressed by this…
New York’s Medicaid program failed to ensure that insurers administering the program were not denying prior authorization requests for mental health services at higher rates than for medical services, an audit report published Aug. 14 by the HHS Office of…
The Pharmaceutical Care Management Association and its members committed to sharing TrumpRx’s cash prices for drugs through their real-time benefit tools and other cost transparency platforms. An Aug. 13 news release said the association coordinated with the Trump administration and…