Smorse

Author's details

Name: smorse
Date registered: May 27, 2015
URL: http://www.healthcarefinancenews.com/content-feed/news

Latest posts

  1. CVS Caremark, Walmart reach agreement to continue in-network coverage — January 18, 2019
  2. CMS considers ending silver-loading in 2020 proposed payment rule — January 18, 2019
  3. How providers in South Carolina and Texas are overcoming telehealth obstacles — January 18, 2019
  4. Decision support can guide clinicians to prescribe lower cost alternatives — January 17, 2019
  5. Patient-directed Utah Health Information Network increases engagement and care management — January 17, 2019

Author's posts listings

CVS Caremark, Walmart reach agreement to continue in-network coverage

CVS Caremark, Walmart disagreed over reimbursement rates in the commercial and managed Medicaid pharmacy network.

CMS considers ending silver-loading in 2020 proposed payment rule

Agency instead offers insurers a reduction in user fees for participating in the Affordable Care Act market.

How providers in South Carolina and Texas are overcoming telehealth obstacles

The two main challenges are proving the value of telehealth and promoting practice change.

Decision support can guide clinicians to prescribe lower cost alternatives

Minor differences in co-payments sometimes mask exponential differences between similar generic formulations.

Patient-directed Utah Health Information Network increases engagement and care management

By empowering patients with a single access point to all their data, the exchange also benefits providers and payers.

ZappRx and Bayer partner to improve access to specialty medications

Providers get a reduced wait time in the prior authorization process, which is usually a manual and paper-based.

CVS Caremark, Walmart clash over reimbursement rates

The retailer is terminating its deal with its PBM, putting commercial and managed Medicaid beneficiaries out-of-network.

Supreme Court hears case over disproportionate share hospital payments

Hundreds of millions of dollars in reimbursement are at stake; $3-4 billion from 2005 to 2013.

Change Healthcare and Health Fidelity partner for greater risk adjustment accuracy

NLP application embedded during coding phase allows for better compliance and more precise reimbursement.

Judge rejects DOJ motion to delay response in CVS/Aetna case due to government shutdown

DOJ also filed a motion to stay the Affordable Care Act appeals case until after funding is restored.

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