• Use Comprehensive Patient Data and AI to Identify Opportunities for Intervention

    Published On: March 17, 2023

    Health plans use technology investments in cloud platforms and artificial intelligence to improve their capacity for predictive modelling, which can lead to improved patient engagement, bottom line performance and HEDIS measures.

  • Compliance 101: Prior Authorization (PARRD API)

    Published On: March 9, 2023

    Brought on by regulatory authorities in an attempt to increase efficiency and interoperability in the healthcare ecosystem, the Prior Authorization (PARRD API) mandate is an initiative designed to improve both the prior authorization process and overall healthcare delivery

  • Compliance 101: USCDI v4

    Published On: March 1, 2023

    USCDI v4 is a ground breaking advancement of the standardized data elements that aims to revolutionize the healthcare industry by further enriching the data being made interoperable.

  • Compliance 101: Patient Access Final Rule CMS-9115-F

    Published On: February 23, 2023

    The Patient Access API mandate may seem like a costly mandate to many payers, but the CMS is indeed effectively pursuing their vision of putting members more in control of their care journey

  • Compliance 101: Payer-to-Payer Data Exchange API

    Published On: February 15, 2023

    The Payer-to-Payer Data Exchange ruling can and will be a transformative mandate that revolutionizes members’ transitions between health plans to ensure continuity of care and improve the overall member experience.