Humana Exits Employer Group Commercial Medical Insurance

Humana Exits Employer Group Commercial Medical Insurance

Humana Inc. made an important announcement today regarding its future business focus. The company has decided to discontinue its involvement in the Employer Group Commercial Medical Products business, which includes various medical plans such as fully insured,...

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Health Data Privacy & Telehealth

Health Data Privacy & Telehealth

In response to the increased utilization of telehealth due to the COVID-19 pandemic, there has been growing concern over how telehealth vendors and practitioners protect and use health data. Policymakers and regulators have proposed or implemented policies to address...

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2023 Final Rule for Marketplace

2023 Final Rule for Marketplace

The Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2023 Final Rule for Marketplace health plans has a Network Adequacy provision regarding telehealth services. As of January 2023, HHS requires health plans to identify and...

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What Is Provider Enrollment

Provider enrollment refers to the process of becoming a participating provider in a health insurance plan or network. This process is typically required for healthcare providers, such as doctors, nurses, and other medical professionals, who wish to provide care to...

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CMS Revalidations Restarted

CMS Revalidations Restarted

In October, CMS began activities that were halted due to the public health crisis including: Application FeesCriminal background checks associated with fingerprint-based criminal background checksProvider/Supplier Revalidation Providers and suppliers that are required...

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UHC Out-of-network provider enrollment

UnitedHealthcare has introduced a new online portal allowing out-of-network providers to electronically register their taxpayer ID numbers  and practice demographics. Prior to submitting claims to UnitedHealthcare as an out-of-network provider, the following...

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Payer Credentialing and Telehealth (Part 2)

Payer Credentialing and Telehealth (Part 2)

It is a New Normal Commercial payers have been forced to accept telehealth services as an effective method of healthcare. Prior to the public health crisis, it was often difficult to obtain a participating provider contract from payer networks for telehealth services....

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