Identifying Anomalies in Claims Data Leads to More Savings for Healthcare Payors
Claritev discusses a data science initiative that identifies anomalies in the data and is helping to improve its Payment Integrity service.
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Should reference-based pricing be part of your healthcare benefits this year?
Americans are concerned about rising healthcare costs, and among the insured, almost half worry about covering their deductible. With the cost of employee benefits projected to rise, employers and employees are looking for ways to lower costs. Ryan Day, President of HST, a Claritev Company, outlines ways reference-based pricing provides value, transparency, and quality in employee benefits.
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Merging Artificial and Human Intelligence to Pursue Payment Integrity–MultiPlan’s Ben Perryman and Evan Pollack to speak at the NHCAA Annual Training Conference
Ben Perryman and Evan Pollack of MultiPlan speak on the combined approach to using both artificial and human intelligence in payment integrity efforts at the NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference.
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MultiPlan Reports Third Quarter 2022 Results and Updates 2022 Guidance
(NYSE:MPLN) MultiPlan reports financial results for the third quarter ending September 30, 2022.
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Navigating the No Surprises Act – MultiPlan’s Susan Mohler to Speak at the Texas Covered Health Care Conference Nov. 8
MultiPlan’s Susan Mohler will present at the Texas Covered Health Care Conference, offering expert insights on navigating the No Surprises Act and helping payors adapt to evolving regulatory requirements.
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Pre-Payment Negotiation Is Beneficial to Payors and Providers in Settling Surprise Bills
The August Final Rule clarified that arbitrators need to consider QPA along with other factors such as provider experience and severity of the patient’s illness. Claritev explores whether this clarification means payors should consider adjusting the strategy they use to process surprise bills.
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Texas Medical Association Challenges Provisions to IDR Process
On Thursday, September 22, the Texas Medical Association (TMA) filed a lawsuit challenging the August 19th Final Rule of the “Requirements Related to Surprise Billing.” The suit challenges provisions concerning the way Independent Dispute Resolution (IDR) entities must treat the Qualifying Payment Amount (QPA) compared to the additional factors described in the law: training/experience/outcomes; provider and plan market share; patient acuity; teaching status/case mix/scope of services of the facility; and prior good faith efforts to contract.
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MultiPlan Announces Participation at Upcoming Conferences
MultiPlan announces participation in the Morgan Stanley 20th Annual Global Healthcare Conference and Deutsche Bank’s 30th Annual Leverage Finance Conference in September 2022.
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MultiPlan Reports Second Quarter 2022 Results
(NYSE:MPLN) MultiPlan reports financial results for the second quarter ending June 30, 2022.
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Midyear Check-In with Healthcare Payors on the No Surprises Act
Healthcare payors who believed they were prepared to comply with the No Surprises Act (NSA) without assistance have realized the new law is more complex than they initially thought. That’s the message Claritev has repeatedly received from clients who elected to try to manage the NSA or parts of it on their own.