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.
Generative AI is altering the way healthcare consumers size up hospitals, group practices and individual providers. But the comparison shopping would pose a challenge to healthcare organizations even if AI hadn’t entered the picture.
A U.S. military contractor has agreed to an $11.2 million settlement with the U.S. Department of Justice to resolve allegations it lied about properly securing sensitive patient data tied to the Tricare program.
In an SEC filing, the insurer argues that requests by investors for more reporting on claims denials may already be satisfied through its regulatory compliance processes.
According to a report from Bloomberg Law, UnitedHealth has hired a prestigious defamation law firm to police what it deems as misinformation posted online.
U.S. House Rep. Greg Murphy, MD (R-NC), scolded the CEO of NYU Langone for buying the expensive ad, requesting in an open letter that the hospital release financial data related to its cost.