Claims Processing

medication errors linked to healthcare technology
By Bill Siwicki 01:13 pm April 28, 2017
Leapfrog Group says 30 percent of hospitals fully meet the four criteria for bar code medication administration, though 74 percent meet the group’s two CPOE criteria.
secure document exchange FHIR for EMS
By Mike Miliard 02:15 pm April 18, 2017
Emergency teams can connect via DirectTrust, Carequality, FHIR and more.
By John Andrews 01:37 pm March 28, 2017
Real engagement means managing hospital workflow, still-emerging relationships with post-acute practices and a complex customer dynamic for payers and providers alike.

From left: McKesson experts David Dyke, Tammie Phillips and Kamron Lachney.

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By 01:12 pm February 12, 2017
Denials erode the provider organization’s bottom line and require an inordinate amount of administrative work for both payers and providers. But they don’t need to.
Surescripts interoperability
By Bernie Monegain 09:33 am August 16, 2016
The network now conducts more transactions daily than Amazon or Uber, according to CEO Tom Skelton.
McKesson HealthQX value-based payment
By Bill Siwicki 01:11 pm July 12, 2016
McKesson expands its ability to support customers in bundled payment programs with HealthQX’s ClarityQx software.
CMS claims data

CMS Chief data Officer Niall Brennan said the new data will enable caregivers to make smarter clinical decisions.

By Bernie Monegain 10:48 am July 05, 2016
New rules under MACRA mean that qualified providers can share or sell analyses of Medicare and private claims data, which the Centers for Medicare and Medicaid Services could be a boon to better care delivery.

"Despite providers' best efforts to submit clean claims, a substantial number still get denied," says RelayHealth's Marcy Tatsch. "An effective denial prevention strategy doesn't just focus on pre-submission, but also on the other points along the claims continuum."

By Bernie Monegain 10:33 am June 27, 2016
Payers reject 6.4 percent of claims on the first go-round, company data show.
Epic EHR go-live revenue cycle ambulatory

St. Luke’s COO Joel Fagerstrom said that the implementation yielded operational and organizational results in just weeks. (Photo source: St. Luke's)

By Bernie Monegain 11:43 am May 27, 2016
While EHR implementations can be disruptive, the hospital system implemented new clinical and revenue cycle software in January and is pointing to its strategy of engaging every employee in the electronic health records system deployment.
Oracle Benefit Management ACA Affordable Care Act Value-based case

Enterprise software giant Oracle aligned with claims processing company Benefit Management to enable payers and providers to adopt new payment models. 

By Jack McCarthy 02:47 pm May 17, 2016
The platform will enable payments to be processed faster, reduce risk for hospitals transitioning to value-based care and ultimately decrease the cost of bundled procedures, the companies said. 

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