Proposed Federal Legislation Intended to Expedite Prior Authorization Approval Process
Recent legislation proposed by the Biden administration aims to address member dissatisfaction with insurance approval wait times. If passed, this rule will apply to prior authorization requests through government insurance…
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Safeguard Your Pharmacy Reimbursement and Avoid Audits
With ongoing medication shortages and astronomical costs for specialty drugs, nearly all members can benefit from medication savings. Furthermore, managing costs helps payers keep reimbursement rates steady for their partners.…
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Exploring the Untapped Potential of Effective Provider Network Management for Health Insurance Executives
Navigating the intricate dance of network adequacy, provider relationships, and regulatory compliance can feel like a continuous tightrope walk. These responsibilities are crucial for member satisfaction and organizational health, yet…
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Prepare for Medicaid Access Changes: What Your Health Plans Need to Know Now
Network inadequacy can create a big headache for health plans, so payers should give special attention to any legislative changes (either proposed or finalized) to these policies. One potential change…
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Do You Value Predictable ROI From Your Provider Network?
TOG Launches Network Intelligence Division Optimizing Payer Profit Margins TOG is now the only health care provider network builder with a network intelligence division that supports the full network operations…
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Record-Breaking ACA Enrollment: What It Means for Your Health Plan
Estimated Read Time: 3 Minutes The Affordable Care Act has hit a historic milestone! Over 20 million Americans are now enrolled in individual marketplace plans – nearly 6% of the…
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