Our annual predictions for 2025 continue with the business of healthcare. Throughout the next few weeks we will be asking the industry experts what they think we will see in 2025. Check back as we cover value-based care, interoperability, virtual care, and how AI will impact healthcare finance, security, RCM, and clinical issues.
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By Mike Lanza – In the stop-loss industry, on occasion there can be tension between the Claim Payer (payer or TPA) and the Stop-Loss carrier when it comes to determining reimbursing claims that exceed the specific deductible. Most claims payers have a claims review process in place to ensure that claims payment follows the Employer’s Plan document.
Our annual predictions for 2024 continues with the business and finance of healthcare in 2024. Throughout the next few weeks we will be asking the industry experts what they think we will see in 2024. Check back as we cover value-based care, digital health, interoperability, privacy, security, access, and equality.