Distributed Healthcare Intelligence
Carenodes Health Enterprise Office of the Executive Dear Health Plan Representative, Please see attached Notice regarding the implementation of Senate Bill 855, Mental Health and Substance Use Disorder Coverage.
Unfortunately, it is in these times of dogged, urgent focus on patient care that health care organizations may be most vulnerable to another invisible danger: cybercrimes targeting the very hospitals tasked with…
Many firms provide coverage for health services delivered outside typical provider settings. Telemedicine is the delivery of health care services through telecommunications to a patient from a provider who is…
The document outlines 47 electronic clinical quality measures (eCQMs) for Eligible Professionals/Clinicians for the 2021 performance period. It categorizes various measures based on quality domains, including effective clinical care, community…
Jan 25, 2021 (AB Digital via COMTEX) — Los Angeles, CA – ComPsych® revealed the 2020 winners for its 16th-annual Health at Work Awards. This award honors organizations that assist…
Healthcare flow of funds explained. Managed Care 101 for healthcare entrepreneurs seeking to do business in the California market. Session led by Alex Yarijanian, CEO Carenodes. The aim: providing healthcare…
Learn to speak the Managed Care Language (101)
KPI / Metric Formula or Definition Target Business Purpose Gross Revenue Gross Revenue or “Top Line Revenue” is synonymous with gross charges associated with the provision of services This is…
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ETHOS AND PROGRAM DESIGN The central premise of the Carenodes Behavioral Health Case Management (BHCM) Program is to promote collaboration between all treating providers, ensuring coordination between medical care and…
Although care coordination did not decrease overall acute health services use, coordination improved clinical documentation of patients’ memory impairment. ED visits may have begun to decrease among patients. Finally, stress…
Carriers set their actual prices by bidding against the capitation payment amounts. Carriers with plans that do well on Medicare Advantage program quality measures get a higher monthly capitation payment.
Before challenging a claim, examine the reason for your denial. The reason for the payer’s denial can be found on the Explanation of Benefits or EOB. In some cases, the…
Carenodes contracts with physicians, facilities and other health care professionals to form our provider networks, which are essential for delivering quality, accessible and cost-effective health care services. In partnership with…
To ensure members are able to access the care they need as the COVID-19 pandemic continues, UnitedHealthcare is expanding cost share waivers for our Medicare Advantage and Individual and Group…
Physical therapist services are generally covered as a basic benefit by all major health insurance companies. Ask your physical therapist to contact your insurance company to determine your specific benefits.
Antisocial Personality Disorders and Implications on Business Operations: Corporate Psychopathology as a Human Resources Agenda Item Publication description The ability of a leader to understand, and level with, employees’ emotions…
Agenda Managed Care 101 for healthcare entrepreneurs seeking to do business in the California market.
E&M Coding Advice Physicians and Medicare alike have struggled for many years with correct coding, documentation, and payment of evaluation and management (E&M) services. That's because, by their nature, E&M…
If you have not updated your practice's fee schedule for several years, you may be in for some surprises. Carenodes Advisory recommends that you analyze and update your fees annually…