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.
The U.S. Department of Justice confirmed that divestitures will be made in 19 of the 20 states at high risk of overconsolidation in the hospice market as a result of the merger. The transaction is now expected to move forward.
When dissatisfied patients slam provider entities in online reviews, they tend to focus on administrative frustrations and thwarted requests. By contrast, satisfied healthcare consumers write quick, list-like rundowns of things that pleased them.
The number is almost double initial estimates. With final data breach notifications now sent, UnitedHealthcare said its investigation into the February 2024 ransomware attack is coming to a close.
Hospitals are awarded Honor Roll points if they rank in one or more of the 15 specialties that U.S. News evaluates, and in one or more of the 22 procedures or conditions for patient outcomes.
The company said in a Securities and Exchange Commission filing that it is cooperating with the Department of Justice’s inquiry into possible incidents of Medicare Advantage upcoding.