Payer Systems

Is a Two-Year-Old Medical Bill Even Legal?
Management & Administration Is a Two-Year-Old Medical Bill Even Legal?

The sudden appearance of a medical bill for services rendered nearly two years prior is a bewildering and financially jarring experience that underscores a significant flaw within the American healthcare system. These delayed charges, often termed "ghost bills," can emerge long after a patient

Democrats Push for a Government Takeover of Health Care
Management & Administration Democrats Push for a Government Takeover of Health Care

A significant shift is underway within the Democratic Party, where the long-standing objective of defending the Affordable Care Act is being eclipsed by a far more ambitious and radical goal: the complete federal government takeover of the American healthcare industry. This movement, coalescing

AI Health Decisions: Patient or Profit First?
Management & Administration AI Health Decisions: Patient or Profit First?

An algorithm, operating silently within a major health insurance system, has just determined that a patient's post-surgery rehabilitation is no longer medically necessary, despite the treating physician's strong objections. This scenario is no longer hypothetical; it is an increasingly common

Can a Bipartisan Deal Save ACA Subsidies?
Management & Administration Can a Bipartisan Deal Save ACA Subsidies?

With enhanced Affordable Care Act health insurance subsidies having expired at the close of last year, millions of Americans are confronting the stark reality of rising healthcare costs, creating a sense of urgency on Capitol Hill. A significant legislative effort to address this issue gained

Cityblock and Meridian Expand Care to Illinois Medicaid Members
Management & Administration Cityblock and Meridian Expand Care to Illinois Medicaid Members

In a state where nearly one in four residents relies on Medicaid for healthcare coverage, the challenge of delivering comprehensive and accessible services to vulnerable populations has prompted a significant new collaboration. Cityblock Health, a healthcare provider focused on serving marginalized

What Do New Rules Mean for Your Cervical Health?
Management & Administration What Do New Rules Mean for Your Cervical Health?

In a significant move toward modernizing preventive healthcare, federal guidelines have been updated to dismantle long-standing barriers that have hindered access to critical cervical cancer screenings for millions. For decades, the standard procedure has often involved challenges of cost, physical

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