Read our experienced team's thought leadership and insight for all areas regarding healthcare claims auditing, payment integrity, provider relations, and cost avoidance.
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?
3 Ways ClaimLogiq is Disrupting the 'Black Box" Model of Claim Auditing Sending claims out for audit and waiting on the results to be delivered without any insight into, or control over, the process, is commonly referred to as the 'black box' model of claims auditing. This is especially true of an often disparate process of reviewing high dollar claims, particularly Itemized bills and DRG validations.