Two Federal Courts Make Rulings on NSA Challenges in Late August
Claritev summarizes changes to NSA regulations and guidance as a result of rulings in TMA3 and AAMS.
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NSA’s Final Rules
On August 19th, the long-awaited final rules under the No Surprises Act (NSA) were issued. Titled “Requirements Related to Surprise Billing: Final Rules,” they finalize certain requirements that group health plans and health insurance issuers offering group or individual health insurance coverage must meet when reimbursing claims determined to be surprise bills as defined by the Act.
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MultiPlan Accepting Applications for 2023 Rural Health Grant
MultiPlan Corporation… is accepting applications for its Rural Health Grant… from rural healthcare providers in the U.S. The grants provide financial resources to introduce or expand services, education, screenings and other programs aimed at improving the health of people in their communities… Grant recipients will be announced in February 2025.
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MultiPlan Reports Second Quarter 2023 Results
MultiPlan reported second quarter 2023 results, with $238.0 million in revenue and $5.7 billion in identified medical cost savings. The company highlighted progress on its growth plan, including a strategic acquisition and new partnerships to expand its technology and healthcare payment solutions.
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MultiPlan Corporation Announces Second Quarter 2023 Earnings Conference Call
MultiPlan Corporation (“MultiPlan” or the “Company”) (NYSE: MPLN), today announced that it will release its second quarter 2023 financial results on Wednesday, August 2, 2023, and hold its conference call that morning at 10:00 am Eastern Time.
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You’ll Never Believe What Our Payment Integrity Team Finds
As a part of Claritev’s Payment Integrity service, we review claims to ensure there are no billing errors and that the charges make sense. When we find mistakes or suspicious charges, we investigate. This blog details our eye-popping findings.
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MultiPlan Appoints John Prince to its Board of Directors
June 27, 2023 – MultiPlan Corporation… announced the appointment of John Prince to its Board of Directors, effective June 26, 2023. Prince has more than 25 years of executive leadership experience in healthcare services and technology… bringing a valuable depth of expertise to MultiPlan’s board… His appointment coincides with the next phase of the company’s growth strategy.
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Tackling Out-of-Network Medical Bills with Data iSight
To tackle the problem of out-of-network charges, Claritev developed our Data iSight pricing methodology. Unlike Usual and Customary (U&C) or Medicare-based repricing solutions, our methodology recommends reductions using both a cost-up approach (for facility claims) and median reimbursement levels (for practitioner claims) to achieve maximum defensibility, wide provider acceptance, and savings of 61%-81% off billed charges.
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MultiPlan and ECHO Health Partner to Drive Health Plan Administrative Costs Down
MultiPlan enhances its claim pricing services by adding payment processing of healthcare provider claims as well as payments made to other service providers. MultiPlan now has the ability to extend payment processing services to payors that price their own claims. ECHO extends its service portfolio to include out-of-network cost management and decision science services.