Blog

Modernizing Premium Billing for Medicaid and Public Program Plans

Premium billing for Medicaid and other public program plans has become increasingly complex. Shifting eligibility rules, fluctuating member responsibility amounts, and heightened regulatory scrutiny place pressure on billing teams to deliver accuracy and clarity at scale. At the same time, members expect timely, easy-to-understand communications that help them stay covered without confusion or disruption.  For government […]
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Utilization Management (UM)-Focused Audits

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

June 27, 2024

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

June 8, 2024

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

June 8, 2024

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

Maximizing Member Retention: Transforming Pain Points into Positive Experiences

Maximizing Member Retention: Transforming Pain Points into Positive Experiences

June 3, 2024

Member retention is paramount in a competitive healthcare landscape. A classic Harvard Business Review study revealed that a mere 5% […]

National Nurses Week

Celebrating Insight and Inspiration: 2024 National Nurses Week Spotlight on HealthAxis’ LPNs and RNs

May 9, 2024

At HealthAxis, we’re immensely proud of our team’s diverse experiences and expertise. This National Nurses Week, we’re spotlighting some of […]

Ethics, Equity, & Data: The Core of Artificial Intelligence in Healthcare

May 6, 2024

The healthcare industry is poised for a transformative era driven by artificial intelligence (AI). AI’s role in automating tasks and […]

Insights from the 2024 HIMSS Conference: Exploring the Future of Healthcare Technology

Insights from the 2024 HIMSS Conference: Exploring the Future of Healthcare Technology

May 1, 2024

The HIMSS Global Health Conference & Exhibition, held in Orlando, Florida, from March 11 to 15, 2024, provided a profound […]

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 2

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 2

April 29, 2024

In Part One of this series, we examined the initiatives Gartner identified as key areas for acceleration,1 following their extensive […]

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 1

Strategic Accelerations: Critical Business Initiatives for U.S. Healthcare Payers Part 1

April 23, 2024

U.S. healthcare payers and third-party administrators (TPAs) face a complex array of business and technology initiatives driven by evolving market […]

National Minority Health Month

National Minority Health Month: Be the Source for Better Health

April 12, 2024

April marks an important observance in the healthcare calendar: National Minority Health Month. This month is dedicated to raising awareness […]

Keys to a Reliable Data Quality Strategy

Building Trust in Healthcare Payer Data: 3 Keys to a Reliable Data Quality Strategy

April 10, 2024

In the age of big data, healthcare payers and third-party administrators (TPAs) are overwhelmed by vast amounts of information, underscoring […]

CMS Final Rule

2026 CMS Interoperability and Prior Authorization: Key Strategies for Healthcare Payer Readiness

April 9, 2024

In January 2024, the Center for Medicare and Medicaid Services (CMS) issued the Interoperability and Prior Authorization Final Rule CMS-0057-F, […]