AUTHOR: Gordon MacMaster

Recent Posts

Returning to Work in the Post Quarantine World

Returning to Work in the Post Quarantine World

A COVID19 outbreak at work? No one wants that to happen. As we get back to work, the spread of COVID19 will continue to be a risk. For exempt essential businesses, COVID19 has resulted in loss of life, shut downs, and disinfection costs like the hotpots below: Everyone is looking for ways to avoid[…] Read More
AI and machine learning revolutionize the health insurance industry

AI and machine learning revolutionize the health insurance industry

Health insurance policy changes at the federal level have captured the headlines in recent years, but in the long run some of the most profound changes to the industry have happened behind the scenes. The application of artificial intelligence and machine learning have impacted some of the industry’s most important practices.

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How to manage overall cost recoveries? 5 ways to recover

How to manage overall cost recoveries? 5 ways to recover

While Coordination of Benefits (COB) and fraud, waste and abuse (FWA) have been a part of the insurance industry for almost as long as there’s been an insurance industry, they’ve taken on a new level of importance for today’s health insurers. Outdated, inefficient and ineffective COB and FWA processes can result in higher payouts, increased administrative costs and decreased customer[…]

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Why health plans lose money on payment integrity programs

Why health plans lose money on payment integrity programs

Health plans make large investments to automate outdated processes when it comes to claims payment integrity expecting significant savings. Unfortunately, with this approach the expected savings don’t always materialize.

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Why is it so hard for health plans to find quality data analytics solutions?

Why is it so hard for health plans to find quality data analytics solutions?

While healthcare is famously complex, it shouldn’t be as hard as it is for health plans to find and manage advanced analytics solutions that take advantage of their unique opportunities and address their specific challenges.

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