January 10, 2025

Commercial payer contracting plays a crucial role in the financial health and operational efficiency of healthcare practices. As healthcare providers navigate increasingly complex payer landscapes, understanding the nuances of payer agreements is vital for ensuring the sustainability and growth of medical practices. Here’s an overview of the critical factors to consider when negotiating commercial payer […]

Prior authorization (PA) has long been a source of frustration for both healthcare providers and patients. While intended to control costs and ensure the appropriateness of care, the process often leads to delays, administrative burdens, and increased healthcare costs. In recent years, several states have taken proactive measures to address these issues, making it a

In the fast-paced world of healthcare, maximizing revenue while minimizing operational inefficiencies is crucial for practices looking to thrive. One powerful tool that can significantly enhance revenue cycle management is AI-powered insurance discovery. By leveraging artificial intelligence, healthcare providers can uncover hidden insurance benefits, optimize reimbursements, and improve overall revenue capture. Here’s how AI can

In the ever-evolving healthcare landscape, physician groups often find themselves negotiating with payers to secure favorable contracts that ensure financial stability and operational success. The terms of these agreements can significantly impact reimbursement rates, payment timelines, and overall practice profitability. As such, it’s crucial for physician groups to understand how to leverage their position during

In early 2020, Intermountain Health set out on a significant mission to expand its Primary Children’s Hospital network by adding a second campus in the thriving suburb of Lehi. This new facility would offer families in the area access to high-quality pediatric care, right in their own community, ensuring timely and convenient healthcare for children.