For healthcare payers, the core administrative processing system (CAPS) is the nucleus of operations, customer experience interactions, billing, revenue realization and workflow management.
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Conduent’s COB solution helped one national health plan recover an additional $5M in funds by automating their matching efforts – enabling them to make coverage determinations earlier.
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The MA market has been dominated by a handful of large healthcare plans, but as demand for these plans grows, more and more regional plans and startups are seeing opportunities to enter the market.
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How Whole Genome Sequencing is advancing public health officials’ mission to protect communities around the world
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Originally established to provide basic health coverage to people with limited resources, Medicaid has expanded to include individuals with permanent disabilities.
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The pandemic permanently altered the pharmaceutical industry and required novel approaches to healthcare provider and patient engagement. Here are some ways that pharma sales will continue to evolve,
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Pharmaceutical manufacturers and payers are often at odds over pricing and barriers to new medication access. Payers will typically initiate a variety of cost containment initiatives,
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