Tag: Medicaid Plans

Value-Based-Care-Plans-improved-health-outcomes-for-MA-members

Medicare Advantage Value-Based Care: Enhanced Health Outcomes

Alongside its positive impact on health outcomes, the Medicare Advantage value-based care plans implemented by an insurance provider resulted in a significant $8 billion in cost savings throughout 2022. Reports from the payer revealed that Medicare Advantage beneficiaries under value-based care exhibited improved health conditions, marked by reduced inpatient admissions and emergency room visits. The […]
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Prime Healthcare hospitals cut ties with UnitedHealthcare, citing low reimbursement

Prime’s New Jersey hospitals will continue to honor the rates and services in the agreements until the end of the cooling off period. The decision impacts Saint Clare’s Health in Denville, Dover and Boonton, Saint Michael’s Medical Center in Newark, and Saint Mary’s General Hospital in Passaic. Dr. Sonia Mehta, regional CEO and chief medical […]
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Don’t Let Telehealth Claims Derail Your Accuracy Rates

Know what to look for when auditing telehealth services rendered during the COVID-19 pandemic. In October of 2019, I presented a telehealth webinar entitled “Foolproof Tips for Billing Telehealth Services.” I talked quite a bit about the telehealth guidelines that were current at the time and made note that “by next year, telehealth is expected […]
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