eBook
Knowledge that empowers you
Explore our e-books to empower your team with the knowledge to excel in a rapidly evolving healthcare landscape.
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January 14, 2026
How to Manage Multi-State Medicaid Regulatory Changes
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November 17, 2025
The Hidden Cost of Inefficient Member Operations
Every health plan intends to improve member experience. Yet most lose time, money, and trust in the very processes built to protect it.
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November 5, 2025
Ready or Not: Six Healthcare Trends That Will Define Payer Strategy in 2026–27
Healthcare payers need more clarity, not theory, as they enter a two-year window of accelerated change. Healthcare trends indicate that AI is becoming operational.
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September 22, 2025
Preparing for CMS Medicare Audits in 2026
By 2026, CMS will audit all 550 Medicare Advantage plans annually. Manual audit prep will no longer hold up. Plans that still rely on spreadsheets
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August 22, 2025
Delegation oversight without the blind spots
Delegated entities like FDRs, TPAs, and vendors are vital to how health plans operate. But they are also one of the biggest sources of CMS audit findings.
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July 31, 2025
AI-Powered Digital Transformation for Health Plans
AI-powered digital transformation for health plans is no longer optional, it’s a strategic advantage. As regulatory demands grow and manual processes stall efficiency, health plans are turning to AI-driven healthcare transformation to modernize operations
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June 30, 2025
From silos to systems: How modern GRC for healthcare payers drives real results
However, many payer organizations still rely on spreadsheets, disconnected tools, and static trackers to manage governance, risk, and compliance.
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May 20, 2025
CMS Program Audit Readiness Playbook
CMS audits are a certainty, not a surprise. But most health plans still scramble, risking penalties, delays, and compliance gaps. This playbook shows you how to move from reactive to proactive readiness, with practical guidance and technology-enabled solutions.
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April 10, 2025
Appeals & Grievances: From Cost Center to Strategic Intelligence Unit
Health plans are under mounting pressure to manage appeals and grievances not just to meet compliance mandates, but to reduce administrative burden, improve member satisfaction.
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September 16, 2024
The Essentials for Healthcare Data Security
In a healthcare ecosystem where cyber risks, data breaches, and compliance audits are rising, securing sensitive member data is no longer optional, it’s critical.
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September 16, 2024
Unlock the Power of AI in Health Plan Operations
Welcome to the future of healthcare management! Artificial Intelligence (AI) is revolutionizing health plan operations, offering unprecedented opportunities to boost efficiency
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September 16, 2024
Embrace Innovation with Rapid Application Development Platforms
In the fast-paced world of healthcare, staying ahead requires innovation and agility. “Why Health Plans Must Consider Adopting Rapid Application Development Platforms”
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September 16, 2024
Unlock the Power of Unified Healthcare Data Management
In the digital age, health plans face a critical challenge: consolidating data from disparate sources to create a single source of truth.
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August 29, 2024
Mastering Health Plan Audit Compliance: A Practical Guide
Are you looking for a way to transform your audit processes into a seamless and stress-free experience? “Transforming Audit Experiences: A Health Plan’s Guide to Stress-Free Compliance”
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August 28, 2024
CMS Program Audit Preparation Guide
Healthcare regulations constantly change. To help create better Member Experiences, this eBook — CMS Program Audit Preparation Guide
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March 16, 2024
Build a World-Class Appeals & Grievances Department
This eBook, Appeals and Grievances for Health Plans: A Playbook for Building an Effective A&G Department, helps payer leaders reimagine their A&G operations for 2025 and beyond.
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