Health Insurance Providers’ Actions Concerning Mental Health

New Jersey Health Care Quality Act (HCQA) and Provider Bill of Rights

The New Jersey Health Care Quality Act (HCQA), N.J.S.A. 26:2S-1 et seq. and rules establish certain rights AND responsibilities for health care providers that contract with carriers for business that is subject to the HCQA. Whether your contract with a carrier is subject to the terms of the HCQA depends upon whether the business for which you are to deliver health care services is subject to the HCQA.

Managed Care Contracts and Health System Operational Alignment

CASE EXAMPLE of how we breakdown contracts and tie the terms to operational alignment Because the business of healthcare is to deliver the highest quality care to patients, improving clinical…

Medical Loss Ratio

The medical loss ratio (MLR) is the percentage of premium that health insurers spend on medical care and quality improvement activities. Prior to the Affordable Care Act (ACA), many insurance…

Health Net, Carenodes, and Insight Choices Expand Access to Telehealthcare

Health Net has grant funded a proposal by Insight Choices, in partnership with Carenodes, to expand virtual healthcare delivery capacity and accessibility. In response to the ongoing COVID-19 pandemic, Insight…

Strong Networks Begin with Strong Healthcare Provider Relationships

As Medicare Advantage plans already know, many factors go into building a robust CMS-compliant network. One focal point should be strong provider relationships. Carenodes is committed to cultivating long-lasting relationships…

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