Resources
My Journey From BUCA to ClaimDOC
The US healthcare system provides an undeniable quality of care, technology, and providers. Yet, these providers are disconnected from the member by a maze of…
Looking Back and Going Forward
As we look back at 2020 from a business perspective, it’s almost mind-numbing to summarize the meaningful events that unfolded. Ultimately, I’m so proud that…
COVID-19 billing observations and information
We released an Audit Spotlight in our last newsletter related to a COVID-19 claim. The claim example generated many questions from the brokers…
Member Education, the key to a successful RBP program
Education is the basis of a successful health benefits experience, especially when it comes to reference-based pricing (RBP). Creating a robust year-round education program that…
Renewal season is upon us
If you think you will flatten renewals this year, you should reconsider. While it is true COVID-19 held utilization down to levels unseen for almost…
New price transparency regulations
Healthcare-related costs continue to soar. The number of patients who are surprised when they receive an astronomical bill for a covered service is also growing…
Full Network Replacement
Traditional program structure for reference-based pricing has included a physician-only network coupled with a vendor capable of auditing and applying revised pricing to facility claims.