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All Claims Processing
Before Claims Fraud, What About Eligibility Fraud?
The multimillion-dollar question is: Are you covering who you think you’re covering? This white paper gives insights into the scope of eligibility fraud among commercial managed care organizations,...
Topic: Business Intelligence
Learn how Atlantic Health Improved Care Coordination and Financial Patient Engagement
Atlantic Health System is leading the way in connecting healthcare providers with one another and with patients to help improve care coordination and patient engagement. Increasing levels of clinical...
Durham Nephrology Associates Achieves Meaningful Use after Navigating Uncharted Waters
Specialty medicine practices rarely employ a dedicated information technology resource. Durham Nephrology is no exception. The Durham practice navigated the uncharted waters of attesting to...
Topic: Meaningful Use
Meaningful Use, ICD-10, RAC & ACOs: A Perfect Storm in the Making?
Every HIM initiative - especially clinical documentation - relies on a single common thread for success: the availability and integrity of the right data to drive the correct decisions and follow-on...
Topic: Meaningful Use
FAQ & A: How Insurance Companies can Overcome Challenges Brought on by Health Care Reform
This paper examines why health care reform is causing a shift to a consumer-driven business model and the role analytics plays in helping organizations make the transformation successfully. Read this...
Topic: Business Intelligence
Payment Policy Optimization: Blending Analytics with Rules to Prevent Wasteful, Abusive and Fraudulent Healthcare Spending
Curtailing the massive drain caused by waste, abuse and fraud in healthcare has never been more impor¬tant. New payment models are on the horizon, including bundled payments, and greater emphasis is...
Topic: Claims Processing
Care Episodes & Bundled Payment: Building and Automating Your Strategy
Hundreds of initiatives for care episodes are already underway in the U.S., relying on myriad combinations of provider types, legacy systems, and techniques. No single system on the market has the...
Topic: Claims Processing