Building on the February 2025 Executive Order, this article outlines the Trump Administration’s continued commitment to advancing patient-centered healthcare through enhanced price transparency. It emphasizes the need to empower patients with real-time access to cost and quality data, enabling informed decisions that drive competition, innovation, and accountability across the healthcare system.
Alternative health plan services often raise questions, and that’s exactly why this Q&A Guide was created. Based on real conversations with brokers and employers, it offers straightforward answers that cut through confusion and help you understand how these plans work, who they’re for, and the impact they can make.
The No Surprises Act (NSA) protects patients from unexpected medical bills, but it also brings new challenges for health plans. In this blog post, we answer key questions about how the NSA works, which claims are affected, and how payors can stay compliant.
The Federal No Surprises Act (NSA) and state-level surprise billing laws share a common mission: shielding patients from unexpected medical bills. However, the mechanisms they use to achieve this goal can differ significantly. From how terms are defined to how disputes are resolved, understanding these differences is essential for compliance and effective administration.
The rapid growth of health plan point solutions has made it harder than ever for employers to determine which programs truly improve member health and deliver ROI. This article explores how a data-driven, population health approach helps employers cut through the noise, identify high-impact solutions, and align benefits strategies with meaningful cost and care outcomes.
Healthcare in 2025 will challenge employers with rising costs, stricter regulations, and growing employee demands—but it also creates an opportunity for brokers to lead. By leveraging data, embracing innovative plan designs, and prioritizing preventive care, brokers can help clients navigate complexity and build more effective, sustainable benefits strategies.
Medical bills are a top stressor among patients and most agree that dealing with them is highly stressful and inconvenient. In fact, 56% of patients report that generally medical bills are a leading source of stress. Figuring out these bills is also often hard, which leads to confusion on top of the anxiety about the cost itself. Therefore, balance bills can add another source of stress.
Data Mining, a post-payment payment integrity service, detects errant medical claims in sets of data. Errant claims typically include duplicate payments and claims with billings issues that lead to overpayments.
On September 20, 2023, the Biden Administration released the first of two pending proposed rules related to the federal IDR process. Claritev discusses it.
A federal court in Texas recently ruled in favor of the Texas Medical Association in its fourth lawsuit challenging the No Surprises Act. Claritev explains the ruling.