Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
The Medicare Advantage insurer said the payout is equal to what a CMS audit stated was the total amount the company was overpaid for patient care services. Despite receiving the cash, the agency has yet to officially withdraw its enforcement action, as the two parties are still negotiating.
A report from Trilliant Health looking at payer data found that, as prescriptions for the popular weight loss drugs spike, so rises the number of approved benefits.
State Attorney General James Uthmeier is forcing the company to hand over thousands of documents related to its pharmacy contracts and reimbursement policies to see if the retail giant is abusing its position in the market as both a pharmacy benefit manager and a retail chain of drug stores.
Medaxiom CEO Jerry Blackwell, MD, MBA, FACC, discusses investor's interest in buying cardiology practices, noting that PE ownership remains relatively low.
Looking at the three largest Medicaid managed care plans related to maternal health, the Office of Inspector General found instances of ineligible providers being included in directories, as well as other errors such as incorrect contact information.
Every industry on earth is buzzing over the promise and potential of ChatGPT and similarly sharp AI models, whether “large language” or another generative form. Healthcare is no exception. But shouldn’t it be?
Fresh off its success using AI to develop a blockbuster COVID vaccine, up-and-coming biotech player Moderna (founded 2010) has won the confidence of 112-year-old Big Blue as a strategic partner.
Cardiovascular Associates of America and Novocardia have joined forces to form what they describe as the "strongest cardiovascular network in America."
Poverty was associated with 183,000 deaths in the United States in 2019 among people 15 years and older, according to a recent study published in JAMA.