Claims Processing
Payers and providers can prevent overwhelming administrative burdens with machine learning strategies that look at patient needs beyond a single transaction, explained Niall O'Connor, chief technology officer at Cohere Health.
This week's top stories include UnitedHealthcare re-examining a policy that allows it to retroactively deny ER claims, Apple adding new health features and Mount Sinai catering to patients with limited English proficiency.
Availity CEO Russ Thomas says his company ensures providers have the information they need to treat and bill COVID-19 encounters.
Zipari CEO and founder Mark Nathan says in last five years, payers have put the focus on consumers by building better transparency and trust.
As patients face increasing financial responsibility, they need to be given a better experience, says Deirdre Ruttle, vice president of strategy at InstaMed.
By analyzing data from payer claims and its own referral-management tracking system, Lawrence General Hospital was able to engage clinicians in strategies for improving care retention.
The scope of changes under MACRA has healthcare organizations concerned they may not be prepared once implementation begins.
Katrina Miller and Esther Lee of L.A. Care Health Plan discuss the challenges of comparing the data from those who fall into the newer Medicaid expansion population against other sets, and the importance of top level support in getting big data initiatives off the ground.
Lee Powe, CIO of Hugh Chatham Memorial Hospital in Elkin, North Carolina, talks about some of the toughest challenges the small community hospital faces, emphasizing the increased costs associated with readmission rates and RAC audits.
Jonathan Bush, CEO of athenahealth, treated the audience to an energetic keynote at Healthcare Datapalooza IV, offering up a great deal of humor and perspective on the state of data exchange, policy and the healthcare system at large.
