While scalability and compliance drive operational success, it’s satisfaction and trust that determine long-term retention. This deep dive explores how the right utilization management partner helps payers improve relationships with providers, enhance member satisfaction, and strengthen clinical outcomes
Outsourcing utilization management helps payers reduce compliance risk, stay aligned with CMS/NCQA regulations, and maintain audit readiness. Learn how BHM delivers daily compliance protection.
Discover how outsourcing utilization management reviews helps payers reduce administrative costs, manage volume spikes, and close specialty gaps.
A clear timeline of U.S. healthcare price transparency, from early state actions and ACA mandates to today’s CMS rules and enforcement.
Explore tips for choosing the right vendor to ensure CMS price transparency compliance, including defining your needs and seeking peer input.
Explore the consequences of noncompliance with the Price Transparency Act. Learn about penalties, recent enforcement actions, and the importance of price transparency for hospitals.
Explore the CMS disclosure requirements driving payer risk and compliance exposure. And how to align governance, vendors, and validation before penalties hit.
Explore how gold carding reduces the burden of prior authorization for healthcare providers by rewarding consistent, guideline-adherent care.
Learn how electronic prior authorization (ePA) transforms healthcare by replacing manual workflows, improving provider experience, and supporting FHIR API compliance.
Learn how FHIR-based APIs make prior-authorization digital, fast, and accurate, boosting provider satisfaction.
