Claims Processing

By Eric Wicklund 07:50 pm June 19, 2010
SearchAmerica, a Minneapolis-based provider of financial clearing services for healthcare providers, has launched Collection Performance Advisor, an analytics-driven software platform that not only guides each account to the appropriate collection team or agency, but also monitors the performance of all collection resources and analyzes the...
By Eric Wicklund 09:37 am June 10, 2010
Health plans and insurers, who have endured the brunt of criticism for soaring healthcare costs, are bracing for change as the nation moves toward reform.
By Mike Miliard 09:40 am June 02, 2010
Florida is famous for its sunshine, but it's infamous for its Medicaid fraud. With the fourth largest program in the country, covering more than 2.1 million people, the state loses as much as $3.2 billion in fraudulent claims each year.
By Diana Manos 09:38 am May 27, 2010
Blue Cross and Blue Shield-initiated anti-fraud investigations have recovered or saved more than $510 million in 2009, according to the Blue Cross and Blue Shield Association, which credits the success in part to technology dedicated to anti-fraud efforts.
By Mike Miliard 10:59 am May 26, 2010
Health insurers, on average, are paying physicians seven days faster and denying 12 to 18 percent fewer claims than last year, according to the fifth annual PayerView Rankings athenahealth and Physicians Practice released Wednesday. The findings show the potential of increased automation and transparency to reduce administrative costs and increase...
By Mary Mosquera 09:24 am May 21, 2010
A Health and Human Services Department panel will debut next month to advise the National Health IT Coordinator David Blumenthal, MD, on the best way to determine the eligibility of applicants for a range of state and federal programs, including insurance plans set up under the new health reform law.
By Mary Mosquera 09:38 am May 13, 2010
The White House has begun developing a strategy for securing online transactions and stemming identity fraud that pays particular heed to the importance of building a trusted arena for electronic healthcare transactions.
By Mike Miliard 10:58 am May 12, 2010
Vanderbilt University Hospital in Nashville, one of the leading academic medical centers of the mid-South and the flagship of Vanderbilt University Medical Center, has selected Allscripts Care Management's discharge planning solution to ensure continuity of care and improve the efficiency of the hospital patient discharge process.
By Mike Miliard 10:55 am May 11, 2010
Intuit Inc., the Mountain View, Calif.-based provider of financial management solutions for small and mid-sized businesses, has signed a definitive agreement to acquire privately held Medfusion, of Cary, N.C., which makes front-office and back-office software designed to improve patient-to-provider communications.
By Patty Enrado 05:33 pm February 03, 2010
Four months after the switch to a new benefits administrator caused a massive claims backlog, the situation for Maryland mental health providers appears to be on the upswing. Even so, more repairs have to be made to the system before things can return to normal, state officials say.