Payer

UnitedHealth Group must redo 67,000 medical claims for behavioral healthcare that it previously denied, a federal judge ordered Nov. 4. 

Insurance claim denials are a costly and time-consuming burden on every hospital and health system. But you can avoid most denials by taking the proper steps. 

Humana saw big profit gains in the third quarter, as the insurer continued to see less utilization due to the COVID-19 pandemic. 

More than 500 Blue Cross Blue Shield of Michigan employees accepted voluntary separation offers after the insurer opened them up to workers Sept. 28, Andy Hetzel, the insurer's vice president of corporate communications, told Becker's Nov. 2.

GuideWell, the parent company of Florida Blue, signed an agreement Nov. 2 to become a majority shareholder in New Directions Behavioral Health, a managed mental health organization based in Leawood, Kan.

Blue Cross and Blue Shield of North Carolina and Caravan Health, an ACO provider, are creating an ACO that will work with rural hospitals and providers.

The following payer executives changed their positions in October.

CMS issued part two of its proposed 2022 Medicare Advantage Advance Notice, which updates payment methodologies to Medicare Advantage and Part D plans.

On Nov. 1, CMS approved Georgia's request to implement a waiver that will change how the state runs its individual marketplace.

Prior authorization workflows remain highly manual in today's healthcare environment, even with advancements in machine learning and robotics process automation.