by Anthony Murray, Chief Interoperability Officer | Feb 26, 2025 | Feature Articles
Clinical data is a two-way street for payers. These organizations require timely and accurate patient data from their healthcare provider partners. Likewise, payers are mandated by the Centers for Medicare & Medicaid Services to make member data available to...
by Brad Hawkins | Jan 16, 2025 | Blog
2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Payers face increasing regulatory demands, heightened expectations for interoperability, a renewed focus on payment integrity, and rising pressure to address...
by Erin Edwards | Nov 20, 2024 | Case Studies
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...
by Amit Shah | Nov 8, 2024 | Blog
One of the most important tools utilized by payers across the country is the Health Effectiveness Data and Information Set (HEDIS), which is maintained by the National Committee for Quality Assurance (NCQA). HEDIS is a measurement set used to determine the efficacy of...
by Erin Edwards | Oct 16, 2024 | Podcast
Healthcare NOW Radio Podcast Network · MRO Exchange: Data Quality with Frank Jackson, SVP of Clinical Quality and Payer Solutions S1E9: Host Mo Weitnauer, Chief Product Officer, interviews Frank Jackson, SVP of Clinical Quality and Payer Solutions, for a thoughtful...
