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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The Future of Healthcare Operations: Agility and Scalability Through BPaaS & BPO

January 30, 2024

In an era where technological advancement intersects with critical healthcare needs, standing still is not an option for health plans. […]

Empowering Healthcare Through Cloud Computing: A New Horizon of Possibilities

January 29, 2024

In the rapidly evolving landscape of healthcare, technological advancements have become crucial in ensuring efficient operations, seamless member care, and […]

Celebrating Data Privacy Day: Where Security Meets Innovation in Claims Processing

January 23, 2024

January 28th marks an important date for all sectors dealing with sensitive data, especially in the healthcare industry. It’s Data […]

5 Benefits of Staff Augmentation for Streamlined Healthcare Payer Operations

January 19, 2024

In the dynamic world of healthcare plans, agility and adaptability are paramount. Shifting member needs, evolving regulations, and fluctuating demands […]

Is Your Post-AEP Audit Simply Checking Boxes, or Unveiling Hidden Gems?

January 17, 2024

The Medicare Annual Enrollment Period (AEP) may be over, but for health plans, the story unfolds beyond simply checking enrollment […]

Checklist for Excellence: 7 Key Elements for an Effective Health Plan Compliance Program

December 29, 2023

In the intricate realm of healthcare, navigating compliance requirements is essential for health plans aiming to succeed amidst evolving regulations. […]

Health for All: Time for Action – Celebrating Universal Health Coverage Day

December 12, 2023

Every year on December 12th, the world unites in celebration of Universal Health Coverage Day (UHC Day). This official United […]

Embracing Compliance Excellence: Recap of Corporate Compliance & Ethics Week 2023

November 10, 2023

To celebrate Corporate Compliance & Ethics Week 2023, we’ve shared resources that highlight our dedication to data privacy and security, […]

CMS Final Rule 2024: Key Updates and Implications for Healthcare Payers – Part 2

November 2, 2023

As Medicare Advantage (MA) open enrollment is currently in full swing, it’s the ideal time to circle back and delve […]

CMS Final Rule 2024: Key Updates and Implications for Healthcare Payers – Part 1

October 26, 2023

With the annual Medicare Advantage (MA) open enrollment well underway (October 15th  – December 7th each year), it’s the perfect […]

Evolving Beyond Legacy CAPS: Breaking Barriers for Payer Transformation

October 20, 2023

In today’s rapidly evolving healthcare landscape, payers face numerous challenges in delivering efficient and effective services to their members. One […]

Top 5 Compliance Challenges in Healthcare Claims Processing and How to Address Them

September 12, 2023

In healthcare claims processing, compliance with regulations and policies is crucial. Payers and providers must ensure that claims are processed […]