BHM Blog
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A Payer’s Guide to Case Management Utilization Review
Explore resolving payer-provider disputes with our guide on case management utilization review for effective dispute management and smoother relations.
Prior Authorization: How Does It Affect Payers?
Prior Authorization is designed to prevent unnecessary expenses. However, the current complexities create challenges for payers, impacting both financial implications and administrative burdens. In this blog post, we will delve into the nuances of prior authorization, exploring its effects on payers and unveiling best practices for a more sustainable and efficient healthcare system.
Mastering Value-Based Care Contracts: A Payer’s Playbook
Master value-based care contracts with our payer’s playbook. Elevate your strategies for effective management.
Top 10 Benefits of Outsourcing Peer Review Management Services
Seeking ways to enhance “paperwork” processes and ensure the quality of care delivered to patients has led to the outsourcing of peer review management services, a strategic move that not only addresses the challenges faced by healthcare providers but also brings forth a myriad of advantages.
Proven Tactics for Accelerating the Revenue Cycle Management Process
Revenue cycle management (RCM) stands as the linchpin that determines the financial vitality of healthcare organizations and payers alike. We will delve into proven strategies tailored specifically for healthcare organizations and payers to streamline and accelerate their revenue cycle.
10 Essential Peer Review Management Terms for Every Healthcare Leader
Embarking on the journey through the intricacies of healthcare, an understanding of pivotal peer review management terms is indispensable. This blog explores the top 10 essential terms that underscore the quality, safety, and efficacy of clinical practices.
Utilization Management: A Cornerstone in Payer Efficiency
Utilization management (UM) is a comprehensive strategy that payer organizations deploy to assess and control the appropriateness of healthcare services. At its core, UM centers around optimizing the utilization of medical resources, ensuring that patients receive necessary care without unnecessary and costly interventions.
Innovating Payer Offerings: Revolutionizing Health Insurance
The imperative to innovate payer offerings has become more pronounced than ever. Health insurance, a cornerstone of the healthcare industry, is undergoing a transformation propelled by cutting-edge technologies, data analytics, and a renewed focus on enhancing overall healthcare solutions.
10 Key Factors for Choosing a Medical Review Company
Choosing the right medical review company is a strategic decision with far-reaching implications. This guide outlines factors to consider.
Enhancing Collaboration in Medical Necessity Criteria
Collaboration between healthcare providers and payers is instrumental in navigating the complexities of medical necessity criteria. By fostering a cooperative environment, both parties can work together to ensure that medical decisions align with the best interests of the patient.