May 2023
  Healthcare price transparency is a crucial issue. Patients, who value clarity about their out-of-pocket responsibility, often struggle to determine the cost of procedures or services before receiving them leading to the passive acceptance of charges and exposure to “surprise” bills that can be financially burdensome or even catastrophic. One way the federal government is driving greater price transparency is through the passage of the No Surprises Act (NSA). Among other requirements, the NSA requires healthcare providers to generate a Good Faith Estimate (GFE) detailing the expected cost… Read more »
April 2023
Author: Morgan Tackett, VP Product Management   When you think about coordinating benefits, you likely think of a costly and time-consuming process with minimal ROI. That’s because many plans take a reactive approach to coordination of benefits (COB) and pay claims before identifying overlapping coverage. This results in the need to recover improper payments which is often performed manually, frustrating to both members and providers, and negatively impacts the entire payment integrity (PI) process.   With more data available than ever before, it’s no longer necessary to rely solely on… Read more »