FHIR has gotten a lot of attention in recent months due to the push for FHIR-based APIs under the new CMS-0057-F ruling in January for prior authorization and interoperability. Specifically, this pushed for greater data transparency and sharing for providers, payers,...
When it comes to the successful implementation and management of a medical management platform project, there are a lot of elements to consider. We recently sat down with Tracy Styles, Senior Director of Program Management, who walked us through the key...
As part of VirtualHealth’s continued innovation, our team has been hard at work to bring reporting, analytics, and insights to a whole new level. Get the inside scoop directly from Kelechi Erondu, Director of Analytics, as he walks through some of the new features and...
Why Payers Need to Start Solving for Prior Auth and FHIR Now Prior authorization APIs and FHIR® are a big deal right now. The recent CMS ruling in January has got a lot of payers thinking, “How do I get this accomplished?” and “Does my current UM platform support...
Health Management Reporting: Looking at HELIOS Reporting Options HELIOS offers a variety of reporting and analytics modalities. From dashboards and views to exportable Excel files and graphic charts, healthcare payers can leverage native reporting functionality and...
Prior authorization can cause serious issues for members and providers if processes are not properly architected by a healthcare payor. More than nine in 10 physicians (94%) reported care delays while waiting for health care insurers to authorize necessary care, a...
A recent survey from Becker’s Healthcare and VirtualHealth revealed what healthcare payers really think about the current state of value-based care and care management. The results show key obstacles still exist.
When people have the knowledge, skills, and confidence to engage in their own health, better outcomes are much more achievable. According to the Centers for Disease Control and Prevention (CDC), this conclusion was based on a research review that linked better health...
In the last few years, challenges related to prior authorization have created inefficiencies in health care that negatively impact both health outcomes for members and the costs both payers and members must pay. That’s why in December 2022, the Centers for Medicare...
This is the final post in a five-part series highlighting top insights from our white paper, Personalized Value-Based Care: Effective Multi-Generational Care Management Strategies. It’s true that meeting the health needs of individuals across generations is partly...