Registered nurses, with targeted training, are the secret weapon in the race for comprehensive care coordination.
Accountable care organizations. Patient-centered medical homes. Value-based reimbursements. Bundled payments. Healthcare is experiencing a revolution brought on by the Patient Protection and Affordable Care Act that aims to put patients squarely in the middle of all their clinical and financial decisions. Payers, including government agencies and insurers, are tying the quality and safety of patient care to reimbursements, making patient-centered care a necessity in all settings.
Healthcare billing and claims handling has become increasingly complex. With the transition to Version 5010 of the HIPAA electronic transaction standards, the expansion of billing codes under ICD-10, and the ever-changing requirements of insurance companies and the Centers for Medicare and Medicaid Services (CMS), it can be nearly impossible for providers to keep up.
Healthcare organizations are facing uncertain times, which is putting strains on their revenue cycle management. Automation can help lower staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.
Healthcare organizations are facing uncertain times, which is putting enormous strains on their RCM. This white paper will show how you can lower your staff costs, enhance clean claims rates, cut denial rates, improve patient collections and reduce bad debt.
In October 2013, S&P Dow Jones Indices (S&P DJI) launched the S&P Healthcare Claims Indices (the indices). This new index series is designed to provide an independent, timely measure of the changes in healthcare expenditures and utilization for individuals enrolled in commercial health insurance plans in the United States.
S&P DJI developed these new indices in conjunction with healthcare professionals at Health Index Advisors (HIA), a joint venture between the premier actuarial and consulting firms Aon Inc. and Milliman Inc. S&P DJI combined its knowledge and experience in developing leading indices with HIA’s experience in the healthcare market to develop the first index series of its kind, based on actual healthcare claims data. These indices seek to increase transparency in the healthcare market and enable the analysis and tracking of changes in healthcare expenditures.
What if you could use just one platform to detect all types of major financial crimes?
One platform to handle the analytical tasks of fraud detection, including:
Data processing and aggregation
Statistical/mathematical/machine learning modeling
One platform that could successfully reduce complex and time-consuming fraud investigations by combining extremely different domains of knowledge including Business, Economics, Finance, and Law. A platform that can cover payments, credit card transactions, and know your customer (KYC) processes, as well as similar use cases like anti-money laundering (AML), trade surveillance, and crimes such as insurance claims fraud.
Learn more about TIBCO's comprehensive software capabilities behind tackling all these types of fraud in this in depth whitepaper.
Published By: Resolver
Published Date: Nov 01, 2019
As risk professionals, you’re tasked with the responsibility to minimize and mitigate risk, all while battling skeptical and reluctant executives for increased budget and more resources. The risk management paradox is a tough pill to swallow. When you’re doing your job well, nobody notices. And when something goes wrong, you’re the scapegoat. So, how do you prove the value of something not happening?
In partnership with The Risk Management Society (RIMS), Resolver hosted a webinar to answer questions many risk managers struggle with:
- How do you prove the value of an ERM program?
- Who is ultimately responsible for risk management?
- What metrics and KRIs should you track to measure the impact of your ERM program?
- How do you encourage risk-based decision making across the enterprise?
- How can technology be leveraged to maximize the value of an ERM program?
Complete the form for access to the full webinar video that will help your team make the case for an ERM program.
Published By: Flexential
Published Date: Oct 11, 2019
This Gorilla Guide covers one of the most important emerging areas of IT infrastructure, but one that still remains a mystery to many: The Edge. This short book aims to take the mys¬tery out of edge computing. By the time you’re finished reading, you’ll have a firm grasp of the ins and outs of the technology, as well as see ways that it’s being used to solve real-world problems.
Published By: Iovation
Published Date: Aug 02, 2019
Insurance fraud is back with a vengeance. With four out of ten mobile claims estimated to be fraudulent, using connected devices have made it easier than ever for fraudsters to commit insurance crimes. Gather insights from the live panel discussion hosted by MoneyLIVE & TransUnion. As fraud experts examine current trends & impacts of insurance fraud in today's digital age and learn how to overcome insurance fraud while protecting your customer relationships.
What you will learn:
Key trends behind fraud and the way in which they are impacting insurers.
How to tackle fraud and identify red flags by using a holistic approach.
Explore trigger points that can help warn insurers of when there is a high chance of fraudulent activity.
Identify the genuine customers and their genuine claims from the fraudsters.
Senior business leaders know what’s good for their O2C processes. But when it comes to a solution like O2C automation, separating fact from fluff can be tricky. This eBook aims to shed light on what execs actually care about in order to simplify the decision-making process. Download now to learn about:
• The 7 critical processes that make up a typical O2C cycle
• The 4 stages of strategic benefits that O2C solutions offer
• Results from actual companies that’ve used O2C automation
Economic and social factors are transforming the way in which organizations define today’s workforce. The confluence of a growing millennial workforce that values flexibility, the rise of automation, and the increasing prevalence of telework challenges organizations to recognize that a workforce is comprised of more than full-time, 9-to-5, career-track employees.
This altered definition of work will ultimately force companies to adjust their recruitment strategies in favor of what candidates are looking for from employers and how such a wide and increasingly remote talent pool will be managed.
To understand the ways in which today’s workforce is evolving and the reasons why recruiters must find ways to adapt to this changing definition of talent, it’s valuable to look at an overview of today’s workforce…This report does just that.
In his time as Director of E-Commerce at Linen Chest, Riaz Faride was faced with a challenge right out of the gate. He found himself responsible for a site that had page load times ranging anywhere from 6 to 30 seconds. Linen Chest’s site was heavy, images were hosted on the origin, and code was never refactored and needed to be optimized. Riaz knew he needed to make some changes, and fast.
What You Will Learn:
Over the years we’ve all heard claims of simple, seemingly magical solutions to solve security problems, including the use of sandboxing technology alone to fight advanced malware and targeted threats.
This paper explores:
• Where sandboxing technology stands today
• Why it fails to meet the needs of organizations
• What’s needed for effective malware analysis
As damaging breaches continue to occur, more organizations are considering endpoint detection and response (EDR) solutions to address the incidents that aren't being handled adequately by their existing defenses. However, EDR solutions come in a wide variety of implementations and can vary significantly in scope and efficacy — choosing the best solution can be challenging.
This white paper, “Endpoint Detection and Response: Automatic Protection Against Advanced Threats,” explains the importance of EDR, and describes how various approaches to EDR differ, providing guidance that can help you choose the product that's right for your organization.
Read this white paper to learn:
What makes EDR such a valuable addition to an organization's security arsenal and why finding the right approach is critical
How the “EDR maturity model” can help you accurately evaluate vendor claims and choose the solution that best fits your organization’s needs
How the CrowdStrike® EDR solution empowers organ
Learn how augmented reality glasses and drones are being used in advanced search and rescue operations.
Epson’s Moverio smart glasses allow drone pilots to have a heads-up, line-of-sight flight experience, resulting in safer, more productive operations.
Moverio enables real-time access to aerial sensor data from a DJI enterprise drone, allowing operators to see:
Imagery through smoke
Locations of victims
How full a tank is
Make the most out of your Enterprise DJI drone with Epson’s Moverio Augmented Reality glasses.
Click now to schedule a demo
Chilmark Research, a global research and advisory firm, recently released a report rating vendors and solutions in the healthcare analytics industry. IBM Watson Health, a leader in healthcare analytics, has put together this infographic comparing how its solutions stack up against some of the closest competitors in the industry in areas such as population discovery and definition, predictive analytics, cost and utilization, and claims data contribution.
Your business may need to keep track of dozens of different
initiatives—but that doesn’t mean you need dozens of
separate storage solutions to get the job done. To reduce
complexity, your business may consider storage solutions
that can take care of multiple jobs at once without sacrificing
performance. For example, if you operate a brick-and-mortar
store and an online store, you should be able to retrieve
customer data from both sources without compromising
transactional database performance. The all-flash Dell EMC™
SC5020 storage array aims to be just such a solution.
Your business may need to keep track of dozens of different initiatives—but that doesn’t mean you need dozens of separate storage solutions to get the job done. To reduce complexity, your business may consider storage solutions that can take care of multiple jobs at once without sacrificing performance. For example, if you operate a brick-and-mortar store and an online store, you should be able to retrieve customer data from both sources without compromising transactional database performance. The all-flash Dell EMC™ SC5020 storage array aims to be just such a solution.
If your organization is one of the 95% of enterprises
that operate in the cloud, you are already grappling
with cloud security. And if your organization is one of
the 85% of companies that use multiple Infrastructureas-a-Service
(IaaS) and Software-as-a-Service (SaaS)
clouds, you have additional issues to consider.
Compared to the days when organizations managed
everything on-premises or only had a handful of cloud
deployments, this new multi-cloud world exacerbates
the expansion of the attack surface and makes threat
containment and accountability more difficult. Further,
pressure on security teams to protect everything in
the multi-cloud environment is leading to reactive and
expensive threat management.
If you are a security leader tasked with meeting the
challenges of a multi-cloud environment, eventually
you’ll find that siloed cloud security strategies fall short
of the mark. But don’t wait. Now is the time to consider
a holistic security approach that reclaims control from
Adversaries and defenders are both developing technologies
and tactics that are growing in sophistication. For their part,
bad actors are building strong back-end infrastructures
with which to launch and support their campaigns. Online
criminals are refining their techniques for extracting money
from victims and for evading detection even as they continue
to steal data and intellectual property.
You’ve heard the stories: a large Internet company exposing all three billion of its customer accounts; a major hotel chain compromising five hundred million customer records; and one of the big-three credit reporting agencies exposing more than 143 million records, leading to a 25 percent loss in value and a $439 million hit. At the time, all of these companies had security mechanisms in place. They had trained professionals on the job. They had invested heavily in protection. But the reality is that no amount of investment in preventative technologies can fully eliminate the threat of savvy attackers, malicious insiders, or inadvertent victims of phishing. Breaches are rising, and so are their cost. In 2018, the average cost of a data breach rose 6.4 percent to $3.86 million, and the cost of a “mega breach,” those defined as losing 1 million to 50 million records, carried especially punishing price tags between $40 million and $350 million.2 Despite increasing investment in security
Fueled by new technologies, expanding regulations and greater patient expectations, there’s a clinical content gold rush in the healthcare market. Sources and types of clinical content grow at an exponential rate and through increasingly refined input methods, including voice and improved OCR, clinicians capture more unstructured information about their patients than ever before. Making all clinically relevant content available together, in one place seems like a simple request. Must the response be so complex?