Payer - PowerPoint PPT Presentation


5G in Healthcare Market

5G in Healthcare Market by Component (Hardware, Services [Professional, Managed], Connectivity), Application (Healthcare Management, Remote Healthcare, AR\/VR, Asset Tracking, Connected Medical Devices), End User (Payer, Provider) - Global Forecast to 2030

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North America Healthcare IT Market to be Worth $344.95 Billion by 2030–Exclusive Report

North America Healthcare IT Market by Product (EMR, mHealth, PHM, RIS, PACS, RCM, Healthcare Analytics, Telehealth, SCM, HIE), Component (Software, Service), Delivery Mode (Web, Cloud), and End User (Hospital, Payer, Ambulatory, Homecare)- Forecast to 2030\n

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Real-World Evidence (RWE) Oncology Market - Offline vs. Online Sales Growth

RWE Oncology Market by Component (Datasets [EHR, Claims, Cancer Registries], Consulting & Analytics Services), Application (Drug Development, Approval, Market Access, Post Market Surveillance), End User (Pharma, Payer, Provider) - Global Forecast to 2029

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Designing a Social Health Protection Scheme for All in Zambia

In January 2015, Luis Frota, Nuno Cunha, and Marielle Goursat presented a plan for social health protection coverage in Zambia. The envisioned scheme includes mandatory enrollment, a single-payer payment system, comprehensive benefit packages, and close links to service providers. Progress has been

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5G Healthcare Market Expected to Reach $166.1 Billion by 2030, Reports Meticulou

5G in Healthcare Market by Component (Hardware, Services [Professional, Managed], Connectivity), Application (Healthcare Management, Remote Healthcare, AR\/VR, Asset Tracking, Connected Medical Devices), End User (Payer, Provider) - Global Forecast t

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Massachusetts All-Payer Claims Database Technical Assistance Group Update

Updates and guidelines regarding the Massachusetts All-Payer Claims Database, including submission deadlines, reporting cycles, and versioning methods. Important information for APCD submitters and liaisons to ensure compliance and data accuracy for various reporting requirements.

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5G in Healthcare Market Worth $166.1 Billion by 2030

5G in Healthcare Market by Component (Hardware, Services [Professional, Managed], Connectivity), Application (Healthcare Management, Remote Healthcare, AR\/VR, Asset Tracking, Connected Medical Devices), End User (Payer, Provider) - Global Forecast t

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Lessons from Mandatory Health Insurance Development and Governance in Estonia

Estonia has implemented a mandatory health insurance system through the Estonian Health Insurance Fund (EHIF) since 1992. The EHIF operates as a single-payer system, pooling public funds predominantly from a 13% payroll tax. Key aspects include high population coverage, independent governance, and f

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Streamlined Workflow for Open Access Publications in Academic Institutions

Streamlining the process of open access publication for academic institutions involves various steps such as author registration, license selection, payer assignment, and billing confirmation. This comprehensive guide showcases a series of visual workflows tailored to ease the navigation of the open

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Update on Technical Advisory Committee Meeting

Initial findings from the joint meeting of the Technical Advisory Committee and the Low Income Energy Assistance Program Subcommittee highlighted the potential benefits of leveraging government assistance programs for low-income rate payer initiatives. Preliminary data analysis revealed discrepancie

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Organizing Strategies for Single Payer Advocacy Within Professional Organizations

Explore tips and strategies for organizing around the topic of Single Payer within professional organizations using resolutions and networking activities. Learn from past successful initiatives and the importance of advocacy within healthcare systems.

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Massachusetts All-Payer Claims Database Technical Assistance Group Update

Update on the Massachusetts All-Payer Claims Database Technical Assistance Group meeting discussing data validation projects, member eligibility elements, use of generic codes for reporting, and guidelines for reporting under different circumstances.

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Feasibility of Care Coordination for Dual Eligibles: Characteristics and Opportunities

The Pacific Health Policy Group's report discusses the feasibility of care coordination for dual eligibles, individuals eligible for both Medicaid and Medicare with high rates of complex health conditions. Characteristics include having low incomes, chronic physical and mental health conditions, and

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Developing a Managed Care Strategy for Orthopaedic Practices in the Southeast

Strategic Healthcare Partners, LLC specializes in assisting healthcare providers, including orthopaedic executives, in establishing and managing effective managed care strategies. This presentation covers key topics such as Medicare Advantage, monitoring payer performance, vetting new carriers, cont

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Cigna Bill for Denial Process Overview

Learn about the new Cigna Bill for Denial process for claims not covered by the primary plan but potentially covered by a secondary funding source. Understand how to submit, identify rejections, and resubmit claims using the new process. Discover the requirements for adding modifiers and notes to fa

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Optimal Billing Practices for Financial Management Change Package

Explore the importance of billing the correct payer and optimal amount, challenges faced, strategies to improve billing practices, and available tools for support. Learn about revenue optimization, meeting objectives, and suggested performance indicators in financial management.

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Overview of U.S. Prescription Drug Spending and Medicare Part D

U.S. prescription drug spending data from 2005 to 2025 shows trends in various payer contributions, with predictions for future years. Medicare Part D's drug spending is broken down, revealing top drugs and rebate percentages. The total Medicare spending in 2015 and average annual growth in Medicare

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Trends in Prescription Drug Spending and Affordability

Prescription drug spending experienced significant growth in 2014, driven by costly specialty drugs. Medicare emerged as a major payer for prescription medications, with notable increases since 2004. While most individuals can afford their prescription drugs, a significant portion still struggles wi

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Introduction to Indiana's All-Payer Claims Data Base (APCD)

Indiana's All-Payer Claims Data Base (APCD) is a comprehensive state database comprising medical claims, pharmacy claims, eligibility information, and provider files from various health plans and insurers. The initiative aims to enhance healthcare policy-making, cost comparison, consumer information

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Insights on 2023 Medicare Fee Schedule & APTA Indiana Prior Authorization Advocacy

Review key updates from the 2023 Finalized Medicare Physician Fee Schedule impacting outpatient PT practice. Understand APTA Indiana's efforts in prior authorization advocacy and learn about tools for member participation. Explore the Payer Reporting Portal and know the process for appealing denied

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Evolution of Payer-Provider Integration in Healthcare

Delve into the historical journey and present strategies surrounding payer-provider consolidation, vertical integration, and provider-led initiatives in healthcare, shedding light on challenges, opportunities, and the impact on care delivery models and financial landscapes.

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