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The Future of Health Plan Administration: How AI and Automation Are Paving the Way for Sustainable Growth

In today’s rapidly transforming healthcare landscape, health plans face mounting pressures to balance operational demands, cost efficiency, and member satisfaction. While artificial intelligence (AI) and automation offer promising solutions, many payers remain hesitant and uncertain about their practical applications and benefits. However, specific technologies like conversational AI and robotic process automation (RPA) are proving their […]
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The Future of Health Plan Administration: How AI and Automation Are Paving the Way for Sustainable Growth
Regulatory Updates

How Regulatory Requirements Are Affecting Medicare Health Plan Administration

The healthcare landscape is constantly evolving and Medicare health plan administrators are facing a wave of new regulatory requirements that […]

Open Enrollment Readiness: Expert Insights from HealthAxis – Enrollment Operations Edition

Open Enrollment Readiness: Expert Insights from HealthAxis – Enrollment Operations Edition

Welcome to the first installment of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series provides health […]

Compliance Updates

What Health Plans Need To Know About Recent Changes In Medicare Compliance

In July, the Centers for Medicare & Medicaid Services (CMS) introduced two pivotal updates that health plan administrators need to […]

Open Enrollment Readiness: Expert Insights from HealthAxis - Compliance Edition

Open Enrollment Readiness: Expert Insights from HealthAxis – Compliance Edition

Welcome to the first installment of our blog series, Open Enrollment Readiness: Expert Insights from HealthAxis. This series is designed […]

Reducing Costs and Complexity with EHR Workflows for Prior Authorization

Reducing Costs and Complexity with EHR Workflows for Prior Authorization

The healthcare industry faces a constant challenge: balancing rising costs with the imperative to deliver high-quality care. Prior authorization has […]

M3P

Navigating the Complexities and Opportunities of the Medicare Prescription Payment Plan for Health Plans

The Centers for Medicare & Medicaid Services (CMS) introduced the Medicare Prescription Payment Plan (M3P) as a part of the […]

HealthAxis InFocus: Leveraging AI Effectively

HealthAxis InFocus: Leveraging AI Effectively

Welcome to the first installment of HealthAxis InFocus, a video series where we share insights and perspectives from our leaders […]

Open Enrollment Readiness

Ensuring a Successful Open Enrollment: Key Areas for Healthcare Payers & TPAs

As healthcare payers and third-party administrators (TPAs) gear up for the open enrollment period (OEP) and annual enrollment period (AEP), […]

Non-Compliance

The Impact of Non-Compliance for Healthcare Organizations

In the intricate realm of healthcare, healthcare organizations confront the daunting challenge of adhering to stringent regulations. Non-compliance can precipitate […]

Utilization Management (UM)-Focused Audits

Critical Prep Areas for 2024 Utilization Management (UM)-Focused Audits

The 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F) introduced new constraints on Utilization Management (UM) policies, particularly prior […]

FHIR® in Action: Streamlining Prior Authorization

FHIR® in Action: Streamlining Prior Authorization

Traditionally, prior authorization has been a complex, time-consuming process fraught with inefficiencies. Disconnected systems and manual procedures not only slow […]

Panel

Investing in Healthcare IT: AI Innovations for Healthcare Payers

The McGuireWoods Healthcare Private Equity & Finance Conference remains a premier event that convenes healthcare industry leaders to explore innovative […]