Healthcare Independent Review and ‘No Surprise Act’
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.
BHM Earns URAC Accreditation as IRO
BHM announced that it has been awarded re-accreditation as an Independent Review Organization from URAC
NCQA UM Accreditation Earned By BHM Healthcare Solutions, Inc.
BHM Healthcare Solutions, Inc., (BHM), a leading supplier of behavioral health and medical review services, announced it received accreditation by the National Committee for Quality Assurance (NCQA) in Utilization Management (UM). NCQA UM (Utilization Management) Accreditation reduces duplicative oversight and inefficient gathering of information by organizations.
Medicaid Expansion Linked To Better Clinical Care
ACA Medicaid expansion, was associated with an increased probability of patients presenting with less complicated surgical disease and a greater likelihood of patients receiving optimal surgical management after admission and linked to better access to surgery and higher quality surgical care, according to a new study from Harvard T.H. Chan School of Public Health.
Opioid Crisis Measures Mostly Fail: Payer Concerns
Payers are stretched to the breaking point trying to manage the onslaught of substance use disorder cases. It’s more important than ever to acquire accurate data to help payers and policy makers establish effective and long-lasting opioid crisis measures.
Health System CEOs Share ‘What Keeps Them Awake’ In Survey
CEOs at hospitals and health systems are faced with increasing headwinds as they look to move forward in an uncertain environment. So what are the key issues and trends CEOs are facing? Deloitte interviewed 20 health system CEOs this year to find out. While none of the key themes emerging from our interviews have really changed since Deloitte last spoke with health system CEOs, the urgency certainly has. Instead of thinking about these issues in a futuristic sense, CEOs are ready to address and tackle them now.
Drug Prices Major Factor For Choosing A Payer Plan
A number of recent reports point to drug prices as the leading factor for choosing insurance coverage, particularly Medicare Advantage Plan. Payers must prioritize decision factors for signing and retaining members, meaning payer involvement in pricing and rebates directly influence member growth.
Workers’ Compensation Benchmarking Study For 2018
Workers compensation treatment guidelines are part of this Workers’ Compensation Benchmarking Study. BHM’s network of case and utilization reviewers meet high standards of clinical experience, especially covering the complex areas of behavioral health. Click HERE and discuss how BHM’s review network can ease review workload.
Cybersecurity Threats Predictions Report For 2018
This year’s “McAfee Labs 2018 Cybersecurity Threats Predictions Report” focuses on the evolution of ransomware from traditional to new applications, the cybersecurity implications of serverless apps, the consumer privacy implications of corporations monitoring consumers in their own homes, long-term implications of corporations gathering children’s user-generated content, and the emergence of a machine learning innovation race between defenders and adversaries.
Telemedicine Services Demand Pressures Payers
2017 Telemedicine and Digital Health Survey reflects a surging demand for telemedicine services among providers and patients, and a broader acceptance of the technology by other major players in the health care industry. In the 2014 inaugural survey three years ago, 87 percent of respondents did not expect their patients to be using telemedicine services by this time. However, according to this year’s survey, those expectations have been defied with approximately three-quarters of respondents currently offering, or planning to offer, such services, and also having strong intentions to grow those programs (53 percent).