Claims

Why Encounters Matter

Encounter data really didn’t matter much 5 – 10 years ago…so what has changed? Health plans typically viewed encounter data as just another output from the claims payment process; that’s…

Read Full Article

What Do NCQA’s Five-Star Ratings Mean?

There are numerous rating systems these days: Rating the top movies, the best restaurants, or that little yellow full-or-half-star on popular e-commerce sites that indicate how satisfied customers were with…

Read Full Article

Configuration Issues Addressed after Critical System Failure

An East Coast health plan experienced one of the worst critical system failures and service issues imaginable. It struggled with getting members on individual health insurance products. The issues deteriorated…

Read Full Article