Availity Essentials Absorbs Individual Plan Management Payspan Enables Seamless EFT and ERA Integration Availity, Inovalon, and Payspan Implement FHIR-Based Reporting LifeWise Shifts to Availity ...

More than half of providers and 43% of payers have yet to start work on the application programming interface requirements of the interoperability and prior authorization final rule, according to a ...

National standards for electronic claims attachments are intended to reduce administrative burden, shorten adjudication delays, and improve reimbursement timeliness versus fax- and mail-based ...

The recent Centers for Medicare and Medicaid Services proposed Interoperability and Patient Access proposed rule is designed to provide patients with easier, more useful access to their health ...

The healthcare industry is unlike any other sector, particularly when it comes to organizing, aggregating and sharing data. Most hospitals and health systems sit between a world of fax machines and ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Rising patient expectations, financial pressures, regulatory complexity, and a shift toward value-based-care (VBC) and payment for outcomes, will shape the healthcare landscape of 2025. Payers (Health ...

Experts discuss the evolving dynamics between payers and providers in oncology, emphasizing value-based care, data transparency, and collaborative reform opportunities. Leaders from the world of ...

Payers are pushing to standardize and reduce prior authorization volume, yet revenue cycle leaders are watching closely to see if these pledges translate into meaningful operational relief. Prior ...

The growing tension between payers and providers is no secret. And it's forcing CFOs to take action. The following is an excerpt from our March cover story. Providers have been fed up with payer ...

A patient’s journey through the American healthcare system is difficult to map. However, there is one experience most patients will certainly face: a disconnected and often oppositional relationship ...