Price transparency is a term that has recently become a leading factor among healthcare payers and providers. It’s a tool used to help patients know the price of a hospital service or product before receiving it. As of January 1, … Read More
Author Archives: manager.inovaare
Enhancing Delegation Oversight: The Role of Technology Solutions in Health Plans
In the ever-evolving landscape of healthcare, health plans are realizing the importance of leveraging technology solutions to improve their delegation oversight programs. By investing in advanced technology, payers can: Today, we will explore the reasons why health plans must prioritize … Read More
What you should know about Part B drug payments to comply with IRA 2022
The Inflation Reduction Act of 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they are administered in the provider’s office (Part B) or used in the ambulatory setting (Part D). The Centers for Medicare & … Read More
2023 CMS Audit Protocols: What You Need to Know
The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs … Read More
ACA Health Plans — Key considerations for staying relevant
A perspective on recent industry shifts influencing ACA plan operations in states, which are yet to adopt ACA Medicaid expansion Health Exchange plans covered under ACA (Accountable Care Act) witnessed 36% enrollment growth between 2021 and 2023. This is the … Read More
Proactive Healthcare Compliance and the Importance of Continuous Monitoring
Proactive healthcare compliance refers to an approach where an organization seeks to identify and address compliance risks before they become a problem. This approach can have several benefits, including: Overall, proactive compliance can help health plans manage compliance risks more … Read More