Where we’re going

Health insurance claim denials are on the rise, creating new challenges for patients, employers and plan sponsors. Behind many of these denials are layers of administrative complexity—such as prior authorization requirements, coding errors and insurers’ cost-cutting tactics that often block or delay payment for legitimate medical services. In 2023, nearly 20% of claims submitted to … Continued

The latest Healthcare Price Transparency Executive Order reaffirms the federal government’s commitment to ensuring that hospitals and insurers disclose actual healthcare costs rather than vague estimates. This action aims to empower patients and create a more competitive market for consumers using health care services. However, plan sponsors and providers may garner greater value from those … Continued