Distributed Healthcare Intelligence
Tallahassee, Fla. - Following Governor DeSantis’ Executive Orders 21-150 and 21-151 in response to Tropical Storm Elsa, the Florida Office of Insurance Regulation (OIR) issued the following notice to all health insurers, managed care organizations…
Insurance companies regularly update their formularies to classify drugs under certain payment categories. It’s best to ask your doctor to help you find out what payment category your drug is…
House Bill 7051, the package of policing reforms negotiated this spring by members of Florida’s Legislative Black Caucus and Republican leaders, was signed into law late Tuesday by Gov. Ron…
Rules regarding telehealthcare in Florida.
There is a large disconnect between what occurs after a patient is discharged from a hospital (acute) and what occurs thereafter. The quality of care is entirely unmanaged, uncontrolled, and…
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.
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…
PIL Letter to the UC Regents To: Office of the Secretary and Chief of Staff to the Regents 1111 Franklin St.,12th floor Oakland, CA 94607 Dear I am writing on behalf of [your organization…
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…
Supplier Directory Data Powered by Socrata
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…