November 2015

Our e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

Enterprise Risk Management (ERM) – Insights into the Future of Healthcare

During Strata Decision’s Summit in Chicago on November 3-5, 2015, several key issues surfaced which may provide some insights into the world of Healthcare for payers. Over 170 health systems and 1000 hospitals gathered to learn how to create their game plans for the future.   Read more >>

Claim Settlement, Medicare, and Medicare Set Asides

A New Document titled Frequently Asked Questions about the Commercial Repayment Center Non-Group Health Plan Recovery Workload Transition is now available. As part of the continuing efforts to improve the Coordination of Benefits & Recovery (COB&R) program the Centers for Medicare & Medicaid Services (CMS) has transitioned a portion of the Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) recovery workload from the Benefits Coordination & Recovery Center (BCRC) to its Commercial Repayment Center (CRC).   Read more >>

Healthcare

The use of prescription drugs is a major expense for treatment of most legacy and chronic claims. In a recent study published in the Journal of the American Medical Association (JAMA), the authors describe an increase in overall use from 1999-2012.   Read more >>