Learn about the challenges, opportunities, and best practices for streamlining compliance and HR operations so your employees can focus on providing a best-in-class experience for your patients.
From onboarding and recruiting to contract negotiations to setup of reimbursement models for claims payments, learn about managing the complexities of provider data and network management for providers and payers for 2022 from ProviderTrust and Virsys12 leadership.
HHS OIG recently released another report about Medicare Advantage organizations including NPIs within encounter data and leveraging these identifiers for program integrity oversight.
Provider directories and the data that power them must evolve to meet the needs of both changing regulatory requirements and an increasingly digital member base.
The Interoperability Rule, currently slated to go into effect in 2021, impacts provider network data for health plans in addition to significant implications for patient health data requirements.
In this post, we’ll provide a framework for refining ownership of provider data and eligibility monitoring in your organization and explore the most common accountability structures we see with health plan clients.
What are the top trends driving provider network innovation and how are provider networks changing? We explore how payers are adapting.
As the meaningful data surrounding the mid and long term effects of the COVID-19 crisis begin to come into focus, one aspect of the dramatically impacted healthcare industry is becoming clear: growing Medicaid MCO enrollment.
Claims leakage in non-par networks should be on the radar of health plan leaders as an important and solvable challenge. Find out why.