A recent audit of National Medicare Health plan, found over $400,000 in overpayments in a 12-month period for multiple diagnostic radiology claims.
Gain the framework needed for understanding medical risk adjustment and the business processes required to perform under a global capitation arrangement.
There are numerous approaches and benefits of a medical claims audit. Understand the types of medical claims audits and how they help everyone involved.
Get the facts about reinsurance and stop loss in provider incentive plans. Review the types of agreements and benefits of stop loss programs.
Medical reinsurance, also known as stop loss insurance is an added layer of protection that help cover situations that are outside even the best predictive models. Understand more about medical reinsurance now.
HEDIS measures, are revised every year and are strictly defined, as are the reporting guidelines. Take a look at the 10 facts about HEDIS reporting our expert team has compiled.
Get the facts about Medicare Risk Adjustment (MRA) and the best practices around implementation. Don't let MRA scare you off, get it right with our help.
An in depth review of the CMS Provider Incentive Plans (PIP) regulations and the Stop Loss Reinsurance requirements from the FRG expert editorial team.
Gain a high level view of what Physician Incentive Plans (PIP) are and how PIP works in today's healthcare industry, dominated by Medicare & Medicaid.