Healthcare Providers Explore Payer Direct Access to EHRs, but Most Are Still Awaiting the Benefits
Healthcare providers are increasingly required to provide clinical data to payers to justify claims and get paid for the care they provide. In one recent study, nearly 15% of all claims submitted to payers for reimbursement were initially denied, including many that...
Navigating the Complexities of Clinical Data Exchange: A Survey-Based Analysis by MRO
Earlier this year, MRO and CHIME surveyed more than 180 leaders at health systems to better understand the challenges of bidirectional exchange of clinical data with payers across seven common use cases: prior authorization, risk adjustment, care management, quality...
Case Study: CareFirst BlueCross BlueShield
Background Summary Learn how MRO and CareFirst partnered to uncover ways to visualize gaps in quality performance, share information, and enhance clinician relationships for insights that drove better patient outcomes. MRO uncovered quality data gaps missed by...
Case Study: Banner Health
Background Summary Banner Health’s large in-house release of information (ROI) operation sought guidance on how to optimize their ROI. They also recognized the need for a new technology platform to manage ROI requests. Essential priorities to meet this need included...