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Independent Review Organization Can Save You Money 3 Ways

2023-10-31T15:03:44-04:00By |Financial, IRO, URAC Accreditation|

The role of the Independent Review Organization (IRO) in the appeals process is to provide an unbiased 3rd party opinion on complicated reviews, helping to assure that all reviews are given the time and care they deserve. It’s a common illusions in the healthcare industry that taking care of things in house is the best and easiest way to save money—however this isn’t true when it comes to claim reviews. If you are trying to manage your denials in-house, it can actually be counterproductive if you’re trying to save money and even time. Let’s take a look at how outsourcing your IROs can save you time and money.

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Cost vs Quality: The Medicaid Challenge Webinar – Last Chance to Register!

2017-04-02T13:28:07-04:00By |News and Events, Webinars|

Learn about Medicaid Reform in 2016. Learn what changes will be made and implemented, with a specific examination of state changes, delivery models, payment impacts, and trends. Join us to discover how Medicaid Reform will impact your organization (whether hospital, provider, health plan, ACO, MCO, or payer) in 2016 and what will be critical to determining success in the upcoming year.

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Study: More Collaboration Aids Health Care For At-Risk Populations

2023-08-07T15:29:13-04:00By |Care Coordination, Health Care Reform, Organizational Analysis|

By teaming with community organizations, doctors and hospitals can deliver high-quality care at good value to disadvantaged people at risk for poor health, according to a new report from a panel of experts. The report released Thursday by the National Academies of Sciences, Engineering and Medicine was produced to aid Medicare officials studying how to fairly pay hospitals that disproportionately serve patients with social risk factors for health problems. Those factors include low income, social isolation, disadvantaged neighborhoods and limited health literacy.

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California Insurance Marketplace Imposes New Quality, Cost Conditions On Plans

2017-04-02T13:28:07-04:00By |Financial, Health Insurance, Health Insurance Exchange, Quality Improvement Programs|

Moving into a realm usually reserved for health care regulators, the California health marketplace Thursday unveiled sweeping reforms to its contracts with insurers, seeking to improve the quality of care, curb its cost and increase transparency for consumers. The attempt to impose quality and cost standards on health plans and doctors and hospitals appears to be the first by any Obamacare exchange in the nation. Among the biggest changes: Health plans will be required to dock hospitals at least 6 percent of their payments if they do not meet certain quality standards, or give them bonuses of an equal amount if they exceed the standards.

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CMS Announces Finalized Mental Health & Substance Use Disorder Parity Rule for Medicaid

2017-04-02T13:28:07-04:00By |Behavioral Health Integration, Managed Care, Medicare and Medicaid, News and Events, Webinars|

The Centers for Medicare and Medicaid Services (CMS) have announced the finalization of a new rule that will help strengthen access to mental health and substance-use services for individuals who receive Medicaid benefits though managed care organizations and those who have Children's Health Insurance Program (CHIP) coverage. According to CMS' press release, this "final rule strengthens access to mental health and substance use disorder benefits for low-income Americans." The new provisions of this rule will benefit the over "23 million people enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP."

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Lunch & Learn: Join us for Workers Compensation: Keeping Claims on Track – a free webinar!

2023-09-12T10:32:05-04:00By |IRO, News and Events, Quality Improvement Programs, Services, Webinars|

Would you like to learn how Workers' Compensation Organizations and Departments like yours are creating cost savings, improving efficiency, and decreasing claim costs? Join us Wednesday, April 13 at 12:00 PM EDT for a free lunch and learn event titled: Workers Compensation - Keeping Claims on Track. If you can’t make the event, don’t worry! Simply register for the web event to receive a recording of the event as well as a copy of the presentation after it is finished.

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1 Day Left to Register! Free Webinar – Behavioral Health Integration: Realizing Opportunities

2017-04-02T13:28:07-04:00By |Behavioral Health Integration, News and Events, Webinars|

This year is going to be an important year for Behavioral Health, don’t miss out on our free webinar 1/20 on Behavioral Health Integration success! Join us Wednesday January 20th at 12: 00 PM CST as we explore the concept of Behavioral Health Integration. This free web event will cover: Making the Case for Behavioral Health (BH) Primary Care (PC) Integration, Integration 101: First Steps to Making it Work (Technology, Screening Tools, Communication), and Integration: Realizing Opportunities. If you can't make the event, don't worry! Simply register for the web event to receive a recording of the event as well as a copy of the presentation after it is finished.

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Contact Us

5601 Mariner St. - Ste 490
Tampa, FL 33609
(888) 831-1171 phone
(888) 818-2425 fax
sales@bhmpc.com

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