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Preferred Provider Organization (PPO) & Facilities Now Can Price Any Claim at Any Specific Rate Automatically!
Healthcare prices set by fee-for-service have a direct impact on the prices paid by insurers throughout the health care system. But one of the most significant changes in the health care delivery system in the past few years has been the shift away from traditional FFS payment methods to managed care arrangements. It has been…
Medicare Claims Editing Simplified and Streamlined to Save Your Time and Investment
Medicare claims repricing is the application of the contract terms to the billed charges between the hospital or the physician practice and the insurance network. And the bill charges are from the healthcare facility or the physician group. As the “claims” is received, it is sent for adjudication to verify certain claim criteria, and then…
How to Avoid Losing Money with Medicare Repricing System
These days, employers struggle to keep up with the ever-rising healthcare costs, especially with high medical claims – how to fund them, mitigate them, and understand how they impact their plan. They face the lack of transparency issue when it comes to repricing Medicare and Medicaid costs across different health plans and networks based on…