Patrick Phillips, CEO of Medicare Advantage technology company Cavulus, predicted in 2019 that the Medicare Advantage landscape would be disrupted by start-ups — a vision that is a reality three years later.
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CVS Health saw COVID-19 expenses drop and government business rise, resulting in an 8.7 percent year-over-year increase in revenue, according to the company's year-end earnings report.
A patient can make sure their healthcare facility is in-network, but still bear a hefty bill if their providers and insurer are out of sync, said Sheldon Jacobson in a column for the Chicago Tribune.
Sacramento, Calif.-based Sutter Health is defending itself in court Feb. 9 over a class-action lawsuit accusing the provider of violating antitrust laws.
Humana has grown from a provider powerhouse in its early years into one of the largest Medicare Advantage payers in the country.
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KLAS Research, a healthcare IT data and insights company, named its "Best in KLAS" payer tools for 2021.
Centene hit the top end of its 2021 revenue outlook, landing at $126 billion largely thanks to Medicare and Medicaid growth.
Three members of True Health New Mexico are suing the payer over an October 2021 data breach that potentially exposed the information of 63,000 members, according to the Santa Fe New Mexican.
Highmark announced that its Financial Investigations and Provider Review department saved the payer more than $245 million by identifying and addressing potential fraud, waste and abuse in 2021.
Cigna is scrapping in court with three Florida-based labs over about $32 million in unpaid claims, but the payer claims it actually overcharged the labs due to a "fraudulent billing scheme," according to court filings.