The law goes into effect on January 1, 2022 In less than a year—by January 2022—payers will have to comply with new surprise billing legislation, and many are scrambling to figure out what it means to them and how to prepare for compliance. As is common with Federal regs, there are ambiguities—such as [...]
Are reference-based pricing and behavioral health related? Reference-based pricing (RBP), or Medicare-based pricing (MBP, as we like to use at ClearHealth) are heating up throughout the industry. There is more and more being discussed in the way of RBP and MBP, and the industry has taken a serious look at the ways to [...]
What should a PPO network look like today? The concept of a provider network has been instrumental in the healthcare industry for more than a few decades. And, whatever the variety of the network in place - HMO, EPO, PPO, ACO - with some nuances, the idea is mostly the same...provide access to [...]
