Obtaining prior authorization (PA) is a complex, time-consuming, and often frustrating process that inadvertently delays access to timely patient care. Pre-authorization requirements are stringent, and there is always the risk that the request to the insurer to cover...
Insurance Verification and Authorizations
25% More Insurers Will Offer Health Insurance Marketplace Coverage in 2015
According to the preliminary data released by the Department of Health and Human Services, consumers will probably have wider choices while shopping for affordable coverage at the health insurance...
CMS Proposes New Quality Measure Changes for Medicare ACO Program
The Affordable Care Act (ACA) necessitates the Centers for Medicare and Medicaid Services (CMS) to launch a shared savings program to facilitate coordination among healthcare providers thereby...
CMS’ New Meaningful Use Rule – A Welcome Step But Not Without Hitches
The new rule released by CMS provides a breather for physicians since it allows flexibility in certified EHR technology for meeting meaningful use in 2014. In addition, this rule finalizes the...
US Medicaid Enrollment Reaches 6.7 Million
The Affordable Care Act (ACA) aims to expand the health insurance coverage to millions of Americans through a combination of public programs and private-sector health insurance expansions. A recent...
Private Health Insurance Exchanges Enrollment Surging
As the implementation of health reforms continues in the US, significant attention has been paid to the state/public health insurance exchanges opened under the Patient Protection and Affordable...
Eligibility for Health Insurance Subsidies in Question
In the United States, under the new healthcare law about 8 million people have signed up for private health plans via health insurance exchanges. However, as per the latest reports from federal...
More U.S. Small Businesses Implementing Employee Health Coverage in 2014 Despite Rising Healthcare Costs, Says NFIB Survey
According to a survey conducted by the research foundation of the National Federation of Independent Business (NFIB), 48 percent of small employers plan to offer employee health insurance in 2014...
Insurance Contracts and Its Implications in Insurance Verifications
If there is something that doctors and healthcare professionals cannot quite manage, it is going through detailed documentation. They have important tasks at hand, providing life saving care to...
Recent Study Reveals 89 Million US People Uninsured from 2004 to 2007
During the period from 2004 to 2007, eighty-nine million Americans were found without any health insurance for at least one month, and 23 million lost the insurance coverage more than once during...
Ensuring Efficiency in the Insurance Authorization Process
Getting insurance authorization is crucial to the success of any practice. Health insurance companies have stringent rules when it comes to making payment. While they pay for medically necessary...