In a new lawsuit, Bon Secours Mercy Health Virginia alleges that Anthem Health Plans of Virginia owes the health system more than $93 million in outstanding unpaid and underpaid claims.
Members of the payer struggling with opioid use disorder can access a full suite of health services offered by Confidant Health that include medication management, therapy, counseling and group support.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
The agency has suspended enrollment in three UnitedHealthcare plans and one Anthem plan for 2022 because the plans did not spend enough of their premium incomes on medical benefits and claims. The payers can contest the suspension, though it is unclear if they plan to.
The senior care provider currently operates 34 medical centers offering healthcare and social services, like transportation. Through the collaboration, the companies will bring more seniors into value-based arrangements with the goal of improving outcomes for Anthem patients.
Homelessness, a key social determinant of health, is on the rise, prompting action from payers and providers. Though their efforts are varied, ranging from subsidizing housing to making it easier for those living in encampments or temporary housing to access care, they have a common goal.
The hedge fund administrator SS&C Technologies Holdings will be the majority stakeholder, while the two payers will each hold a minority interest in the joint venture, dubbed DomaniRx. The company will develop a claims adjudication platform to support its operations.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
UnitedHealthcare is instituting a new policy beginning July 1 that changes how the payer assesses emergency department claims, allowing it to retroactively deny ones it deems "non-emergent" or not an emergency. The American College of Emergency Physicians has made its opposition clear, stating the policy may violate federal law.
The EHR giant will integrate its payer platform with the insurer's operating system to facilitate two-way data exchange with providers. Through this integration, the organizations hope to support clinical decision-making and streamline administrative processes like prior authorizations.
Bright Health has filed preliminary paperwork for an IPO, joining its rivals in the insurance technology space in going public. Though there are few confirmed details at the moment, Bright Health is reportedly looking to raise $1 billion through the offering.
After acquiring startup Doc.AI, Sharecare is going public through a merger with a Mnuchin-backed special purpose acquisition company. In a recent filing, the company disclosed it had received $50 million in backing from Anthem.
Executives from Imagine360, Verily, BrightInsight, Lantern, and Rhapsody shared their approaches to reducing healthcare costs and facilitating digital transformation.
The Delaware Supreme Court ruled on Monday that Cigna can’t seek a $1.85 billion breakup fee after its failed merger with Anthem, upholding a judge’s decision last year.
The California-based provider has filed a lawsuit against the payer, claiming Anthem has yet to pay for the care it provided to patients covered by its affiliate. Stanford and Anthem had an implied contract, and if it is not upheld by the court, the provider is seeking $1.9 million in reimbursement.
The new joint venture will bring K Health's artificial intelligence-driven technology to the consumer, employer and insurer markets. The solution enables patients to understand their symptoms and connect with a doctor if needed.
Insurer participation in the ACA individual marketplace is on the rise and the trend is driven by policy changes at the federal level and the lingering effects of the Covid-19 pandemic.
Digital health startup Sharecare plans to go public through a merger with a blank-check company created by Alan Mnuchin. The deal will value the company at $3.9 billion.