Tag: healthcare data exchange

Why Healthcare Providers Need Medical Claim Clearinghouses

Medical claim clearinghouses enhance the efficiency of claim submissions for healthcare providers, thereby reducing costs and improving payment accuracy. Each year, healthcare payers and providers exchange billions of claims to finalize patient encounters, a number that continues to rise. As claim volumes increase annually (except for a dip in 2021 due to the COVID-19 pandemic), […]
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Interoperability-and-Prior-Authorization

CMS released the CMS Interoperability and Prior Authorization final rule

CMS Interoperability and Prior Authorization Final Rule: On January 17, 2024, the Centers for Medicare and Medicaid Services (CMS) published the CMS Interoperability and Prior Authorization final rule (CMS-0057-F). The final rule aims to reduce the burden on patients, providers, and payers by consolidating the authorization process and moving the industry electronically. Affected payers must […]
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Medical billing and interoperability

Interoperability role in medical billing: A growing number of physicians practice in an interconnected world, which means that medical practices and hospitals need to seamlessly share information in order to be able to provide good health management and ensure that patients are treated safely and effectively. Health care interoperability is an important concept that has […]
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