Payer executives are increasingly focusing on claims management to cut costs. Prepayment review offers a proactive approach compared to traditional post-payment methods, allowing payers to identify and address potential issues before claims are processed.This episode is sponsored by CERIS.
Becker’s Payer Issues Podcast
This podcast discusses the upcoming Health Equity Index (HEI) replacing the Reward Factor in Medicare Advantage Star Ratings with Dr. Ashwin Patel, the Chief Medical Officer at Pyx Health. Learn how this impacts plans in 2024-2025 and what steps they…
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Tune into this episode featuring Rehan Mirza , Chief Growth Officer at Verifiable, and Dara McDaniel, Associate Director of Credentialing at Humana. Dara and Rehan share insights on credentialing outside of patient safety and compliance, new approaches to leverage…
In this episode, we explore how member engagement and care navigation are crucial for value-based care, population health, and member satisfaction. We discuss the challenges health plans face and the opportunities presented by AI technology. Our guest, Amanda L. Bury, MS…
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In this episode, Dr. Bloom returns to discuss the specific challenges and opportunities in supporting preventive care for patients with complex diabetes. We explore how value-based care models can align with best practices in this area, and what future shifts…
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The rising tide of chronic diseases threatens healthcare costs. In this episode, we are joined by Dr. Sam Toney, CEO of Toney Healthcare, as we explore how payers can leverage care management programs to address this challenge. We discuss the…
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Payers are on a mission: boost growth and improve member experiences. But navigating new technologies and reducing costs can be tricky. This episode dives into the top challenges and opportunities payers face, plus expert advice on how to streamline operations,…