Claims Processing
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.
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.
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...
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.
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.
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.
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.
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.
