Posted and filed under Healthcare, Payers.

HEDIS Season: The Home Stretch

As we approach the month of June, we also begin our downward slide towards the end of HEDIS season. HEDIS season, in all its glory, stretches through about 3 calendar seasons – and requires hard work from providers, chart reviewers, and record collection companies from December through October – depending on program enrollment, measures, and…

Read the full article

Posted and filed under Compliance, Healthcare.

OIG Medi-Cal Audit Reveals $70M in Incorrect Payments

Earlier this month, the Office of Inspector General released a 29-page audit report of an investigation conducted on the California Department of Health Care Services. The audit, which covered the review of more than 112,000 Medicaid capitation payments amounting to nearly $74 million dollars was initiated to determine whether California had made capitation payments on…

Read the full article

Posted and filed under Healthcare.

The Healthcare Affordability Problem

When it comes to paying for healthcare, Sophie’s Choice becomes Everyman’s Choice. Would you rather feed your family or get that questionable mole biopsied? These are the types of questions otherwise well-adjusted families are forced to make on a regular basis. A recent Kaiser Family Foundation report revealed that the state of healthcare affordability is…

Read the full article