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Health Insurance & Benefits
Plan types, HSAs/FSAs, open enrollment, and navigating coverage denials/appeals.
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Electronic Prior Auth Standards Roll Out for Medicare Advantage, More
4+ hour, 7+ min ago (558+ words) The final rule affects: The APIs must also communicate whether a payer approves, denies, or requests more information for each prior authorization request. “It really truly is the right direction,” said Brian Bruel, MD, a member of the Texas Medical…...
AMA Tells CMS the Argument for Delaying the 2027 Electronic Prior Authorization Deadline Is a Manufactured Problem
13+ hour, 29+ min ago (677+ words) A September 18 letter from the nation's largest physician group warns that relaxing enforcement next year would leave doctors relying on faxes and phone calls while patients wait for approval of needed care. According to Becker's Hospital Review, the letter says…...
Oz: Medicare Advantage a garden???vulnerable to weeds and overgrowth???
12+ hour, 1+ min ago (752+ words) The CMS administrator’s comments Tuesday at an event hosted by an MA lobby suggest that the Trump administration remains interested in tougher oversight of the program. According to CMS Administrator Dr. Mehmet Oz, regulating Medicare Advantage is like lovingly tending…...
Insurers deny less just to claw back more later: analysis
23+ hour, 14+ min ago (453+ words) AndreyPopov/istock via Getty Ima Claim denial rates are down across payers, but healthcare providers are not seeing an overall increase in revenue, according to a new analysis from Kodiak Solutions. The overall initial claim denial rate for providers fell…...
Medicare Advantage Risk Adjustment: Why CMS's Payment Cuts Didn't Raise Premiums – RamaOnHealthcare
1+ day, 5+ hour ago (142+ words) Smart Topics: Rama SmartSearch identifies popular industry keywords as "Smart Topics" and searches article titles for related industry keywords. You may simply combine keywords to narrow search results. Alternatively, you may use the "AND" operator to also combine keywords. You…...
You Can Save Hundreds on Your Medicare Supplement Plan By Shopping Around — But Timing Is Key
15+ hour, 14+ min ago (923+ words) Your Medigap plan could be significantly cheaper with another carrier. It's easier than you might think to switch — but beware of the timing trap that can trip you up. That instinct might make sense for other types of insurance. But…...
Need A New Medicare Advantage Plan This Year?
1+ day, 4+ hour ago (60+ words) Geisinger Health Note: A number of things could be going on here. - If you are attempting to access this site using an anonymous Private/Proxy network, please disable that and try accessing site again. - Due to previously detected malicious behavior…...
Former Glasgow dental practice could become flat in Dennistoun
1+ day, 14+ hour ago (239+ words) A former dental practice in Glasgow's East End could be transformed into a home under plans submitted to Glasgow City Council. The application seeks permission to change the use of a property at 3 Whitevale Street, Dennistoun, from a dental surgery…...
Plans to convert Blackpool shrine into mental health centre rejected
1+ day, 23+ hour ago (370+ words) Planners have rejected the proposal to convert the Thanksgiving Shrine of Our Lady of Lourdes on Whinney Heys Road in Blackpool into a mental health centre. The plans were rejected by the planning committee as they saw, “no clear local…...
Residents fear return of crisis unit to quiet cul-de-sac in south Essex
3+ day, 14+ min ago (444+ words) Residents fear a mental health crisis facility could return to their south Essex cul-de-sac, bringing back anti-social behaviour and parking problems. Plans submitted to Basildon Council would turn four homes at Weymarks, Laindon, into a 13-bed crisis facility for adults…...