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Claims Processing

By Eric Wicklund | 11:45 am | September 08, 2010
Payers aren’t always in the loop when physicians and patients get together to map out a healthcare regimen. IBM is looking to the clouds to change that.
By Mike Miliard | 12:08 pm | September 01, 2010
Thomson Reuters announced Wednesday that it has acquired Healthcare Data Management, Inc., a King of Prussia, Pa.-based health plan benchmarking firm that will now become part of the Healthcare & Science business of Thomson Reuters.
By Diana Manos | 11:53 am | August 13, 2010
The Department of Health and Human Services, Office of the Inspector General is recommending that the federal government crack down on physicians who have incorrectly coded their Medicare claims for the wrong place of service.
By Tom Sullivan | 09:54 am | August 06, 2010
ICD-10 is a multi-headed beast. As such, there are many faces to the new code sets; some are well known while others, often just as important, are not so understood.
By Mike Miliard | 11:06 am | July 15, 2010
IBM announced plans Thursday to enlist some of its leading scientists and technologists to help medical practitioners and payers provide high-quality, evidence-based care to patients.
By Chris Anderson | 11:56 am | July 09, 2010
In a partnership aimed at helping both insurance carriers and employers, out-of-network specialist Progressive Medical and StoneRiver Pharmacy Solutions announced yesterday the broad availability of a combined electronic service that will aid in correctly identifying payers for out-of-network pharmacy benefits.
By Chris Anderson | 11:55 am | July 08, 2010
The TriZetto Group Inc. announced this week a partnership with professors who founded the value-based insurance design movement to develop chronic-condition templates as options for healthcare payer customers of TriZetto's Value-Based Benefits Solution.
By Bernie Monegain | 10:49 am | July 01, 2010
The Department of Health and Human Services unveiled a new Web site Thursday that officials say will help consumers take control of their healthcare, connecting them to information and resources that will help them access quality, affordable coverage.
By John Andrews | 10:18 am | July 01, 2010
Real data and real results tell the story of the pay-for-performance movement, but market specialists say it starts with the vision of what an organization aspires to be and the priorities it sets.
By Bernie Monegain | 10:16 am | July 01, 2010
A healthcare price-comparison startup started by the founder of RelayHealth and the co-founder of athenahealth has raised $60 million in funding, including an investment from the Cleveland Clinic.