#operating rules

Mostly that's photos and information about The Untamed, the Untamed cast, and of course, the doings of my favorites - Wang Yibo and Xiao Zhan. (Along with political stuff because my country is a hellscape right now and I am not going to keep quiet about it.)

If it isn't apparent, I am a Yizhan bjyx shipper, a Turtle. If you aren't, that's fine by me. Unless you stomp into my blog and start trying to tell me I'm wrong or delusional about the guys. Because if you do that - we're going to have Some Words and then I will block your ass. I am way too busy to give TOXIC people of any stripe either my time or oxygen in my space. I don't stomp into the blogs of others shaking a metaphorical finger at them and I will not put up with that nonsense here.

Is unified enrollment channel solution to Payer business?

An Enrollment Management system that supports and enforces real-time integration with enrollment channels for commercial, Medicaid and Marketplace lines of business, providing end-to-end visibility into the entire enrollment process.

CORE Compliance from 'what' to 'how'

The technical issues that are commonly faced when implementing and maintaining compliance with eligibility transactions. Everyone must support real-time request – response transactions within defined response times. This requirement impacts multiple application and infrastructure teams.

Operating Rules, business transactions and administrative simplification savings opportunities

Given the stiff penalties for health plans who don’t comply, these educational sessions will help ensure that your organization has assessed and prepared every line of business.

To certify or not to certify? That is the question.

The NPRM assumes that there are 3,000 to 5,000 health plans that will need to comply with the Operating Rules mandate. While the actual number is unknown, it is widely believed that the number of health plans that will need to comply with Operating Rules is currently underestimated.

Executive Round Table: CORE Operating Rules

Join industry leaders from CAQH CORE, eHealth Initiative, Aetna, and Edifecs as they discuss their perspectives on Operating Rules. This webinar will allow you to participate in the very pulse of the Operating Rules conversation and understand the positions of the biggest names in healthcare IT.

Tips and Tricks For Operating Rules implementation – Calculating ROI

It is a best practice to estimate the ROI on any new project and Operating Rules are no exception. Let’s see how the Operating Rules ROI calculation is going to be helpful in the long run. While employers and insured want to know how this benefits them (lower rates, better services, etc.) it’s also important to measure the savings from this implementation to show the benefits of Operating Rules to your business and to justify funding for future phases of Operating Rules implementation.

The Unknowns Of Healthcare Operating Rules

The lack of opinions, white papers and blogs on Operating Rules compares palely with other more marketed reform initiatives (that’s right, Operating Rules are also part of the ACA).