The court stressed that “[t]he fact that [Blue Cross] could make claim payments only with the Fund’s authorization, along with the fact that the Fund retained full control over the appeals process, weighs toward finding that [Blue Cross] lacked authority respecting the disposition of the working capital amount.”
Continue reading First Circuit Holds Blue Cross Was Not a Fiduciary When It Allegedly Overpaid, Repriced, and Mishandled Benefit Claims
For the underwriting process, the insurer receives detailed patient information at high resolution, from the questionnaire answers to results from specific lab tests. This data is used to completely personalize the insurance product, whether for pricing and actuarial purposes, underwriting, or management of the lifecycle of the policy and claims management. MPCheck supports a fully tailored approach to health insurance, and a completely different and more effective mode of risk management.
Continue reading How Breakthrough Technology Is Revolutionizing Medical Underwriting
Sheba Virtual Hospital “Beyond” is making it possible for people to perform periodic medical examinations at work or at home.
Continue reading New Development In Virtual Hospital Will Make Being Healthy Easier
This year, the Texas Legislature has the opportunity to repeal the anti-competitive, out-of-date state law guaranteeing Medicaid business to underperforming health plans.
Continue reading Mandatory Government Contracts Benefit Low Performance Health Plans