Tag: health plans

Third-Party Reviewers: Offering Streamlined Solutions for Payment Integrity

Unfortunately, the healthcare industry faces challenges with financial waste. It has been estimated that the healthcare system in the United States wastes approximately $765 billion annually, about 25 percent of what is spent. Part of this number is due to payment integrity issues such as fraud, waste and abuse (FWA). If you’re not familiar with […]

How Healthcare Organizations Can Tackle Social Determinants of Health

There’s no way around it–healthcare in the United States is expensive. This country spends about twice as much per person compared to other developed nations. One key way healthcare organizations are addressing these issues is factoring in social determinants of health (SDOH). The World Health Organization defines SDOH as “the conditions in which people are […]