How Pre-Authorization Works in Healthcare (And Why It’s Broken)
Pre-authorization-also known as prior authorization, pre-certification, or precertification-is a utilization management process used by health plans to...
Claims & Appeals
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Pre-authorization-also known as prior authorization, pre-certification, or precertification-is a utilization management process used by health plans to...
Telemedicine for speech therapy (often called tele-SLP ) is usually introduced as a convenience benefit: fewer car rides, easier scheduling, and faster...
Telemedicine is everywhere now. But gastrointestinal (GI) disorders are where a lot of virtual care programs quietly break-then employers end up paying for...
Yes, you can purchase short-term health insurance, and many individuals use it as a gap filler between jobs or during open enrollment transitions. However,...
Checking the status of a healthcare benefits claim online is often simpler than calling customer service, and it gives you 24/7 access to your information....
Mental health parity fundamentally reshapes how employee benefits plans must treat mental health and substance use disorder (MH/SUD) benefits compared to...
Virtual care for kids with autism is usually pitched as an access win: fewer waitlists, fewer miles in the car, fewer missed workdays. All true. But if...
The penalties and costs for using out-of-network healthcare providers can be substantial, often leading to what's known as "surprise billing" or significant...
Most DEI benefits initiatives sound great in the announcement email. More inclusive coverage. More vendor partners. More “support.” Then six months later,...
Coordination of benefits (COB) is the legal and procedural process that determines which health plan pays first and which pays second when you have dual...
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