About Eric Duchinsky

Resources by BHM Healthcare Solutions

CMS Star Ratings Major Setback for 2 Insurers

2022-11-10T19:16:20-04:00By |Readmissions, Utilization Management|

The federal government hit CVS Health and Centene with lower quality scores for the health-insurance plans they sell to seniors. Star Rating scores are a big deal for health insurers, because plans that score 4 stars or higher receive bonus payments from the federal government that they can use to edge out competition by funding new health-plan benefits to attract more customers.

Healthcare Independent Review and ‘No Surprise Act’

2022-10-19T14:51:08-04:00By |Healthcare Independent Review, IRO, Payer Trends|

Understanding the Vital Role, Challenges, and Opportunities of Independent Medical Review Services, offers a behind-the-scenes look at internal and external appeals, reasons why accredited IROs reduce risks, and a crash course on newer review services, such as the independent dispute resolution process that’s part of the No Surprise Act (NSA) surprise billing regulations.

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