Read our experienced team's thought leadership and insight for all areas regarding healthcare claims auditing, payment integrity, provider relations and cost avoidance.
All payment integrity programs are not created equal. The process for implementing a payment integrity program will look different for every healthcare plan -- and for good reasons. However, it is possible to successfully implement these differing payment integrity programs in under 90 days with the right business partnership and aggressive (yet very achievable) tactics and strategies. 90 days might seem ambitious, but, when payers work with a partner that is capable of bridging any gaps in the implementation process, it is possible to achieve swift implementation timelines. When we approach all client relationships as true business partnerships, it benefits all areas of every program execution. Our operational execution is second to none, our team is stacked with experts with decades of experience in the payment integrity space, and our TrueCost solution offers transparency, client-driven control, customizability and flexiblity to meet every need. These factors are what sets ClaimLogiq apart -- not just during the implementation phase -- so we're ready to move as fast as our clients can when it comes to crossing major milestones of any program implementation.
In the world of healthcare, claims audits can be complicated. It’s no wonder most healthcare plans that don't have the bandwidth to spend days analyzing stacks of paperwork - opt to outsource their claim reviews to third-party vendors in order to alleviate the burden.
Some of the trends on the horizon this year may be familiar as they’ve been emerging over the years. The healthcare industry is nothing short of a behemoth and although not resistant to change, it can be rather slow to adapt, even when health crises demand it. However, the eruption of COVID-19 in 2020 and the continuation of the pandemic into another year has put pressure on the healthcare industry to make rapid advancements and sharply change direction, in many cases.
At ClaimLogiq, we pride ourselves on the credibility of our data. The millions of dollars in charges that we save our clients mean nothing if they can’t trust our rationale or that the data is safe and secure.
At ClaimLogiq, we are a technology and software company focused on innovating the often-archaic methods of claim auditing. Payment integrity, in the past, has meant manually looking through a stack of paperwork to check thousands of lines of medical codes for errors. We're making claims logical through the use of technology. Our HITRUST CSF certified platform is able to find IBill errors in 20 minutes -- compare that to the two-plus days that checking the stack of paperwork would take. SaaS, or Software-as-a-Service companies are known for innovating and automating work that can solve all kinds of problems. But have you ever found yourself asking "Why can't I just talk to a human!?" Sometimes, SaaS companies can solve one problem with technology, but unknowingly cause another due to lack of personalization and customization for the client. At ClaimLogiq, however, personalization, customization, and excellent communication are some of our core values. Not only are they built into the foundation of our software, but we uphold them in our client relationships and our work every day. As our tagline states, to us, it really is personal. But how do we prove it?
Scientists and doctors are constantly innovating to find new and better ways to learn about, treat, or even cure ailments or diseases that affect us. There will always be a newer, possibly better solution on the horizon. However, innovations in healthcare shouldn't be taken for granted. In fact, it's important that we don't think of innovations in health care as expected or able to be achieved with the same players, but rather, encourage those willing to find new solutions to do so.
The impact of the pandemic hasn't been a ripple effect, it's been more like a shockwave to the healthcare industry, insurers and employer health plans (just to name a few in the payer space). It's safe to say no matter who you are, there is an immediate visceral reaction to the impact "Coronavirus" or, "COVID-19" is having on lives, every day. Specifically, the impact on employer sponsored health insurance plans revolves around massive job losses and, although the immediate affect has been staggering, as we enter the second half of 2020, there appears to be some up-ticks in positive notes about the still, very challenging road ahead.
COVID-19 caused a drastic decrease in in-person care. Nearly overnight, anyone displaying symptoms of the virus was urged not to walk into their medical clinic without calling ahead and making sure it was necessary. With COVID-19, suddenly, telehealth was more necessary than ever before. So – where do we go from here? If this is the new normal for doctor’s visits, is it good enough? How do we make it better? And how?
Industry News: Health insurance companies are calling on Congress to provide more funding to help people keep coverage, citing the more than 44 million who have filed for unemployment since the coronavirus crisis started. The two main health insurance lobbying groups, America’s Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association, wrote a letter to congressional leaders on Friday making a range of requests for the next coronavirus response package, expected later this month.
What are the costs for payers, providers and patients in moving towards a historic healthcare price transparency model? We know that payers and providers negotiate specific pricing tiers and strategy regarding both small and complex healthcare visits and procedures, but, what would that look like up-front to the patient?