Category: Health & Wellness

Medicare Advantage Spending Surge: What the 2023 Data Reveals & What Your Health Plan Needs to Know

BY TOG Network Solutions | May 15, 2024

A review of last year’s data shows a spike in service utilization for members with Medicare Advantage (MA) plans in 2023. This information came from an AHIP survey, which found…

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Inaccurate Reports of Vaping History Impacting Health Insurance Premiums

BY TOG Network Solutions | Apr 17, 2024

Vaping has been highly criticized due to its negative health effects, especially as the Food and Drug Administration (FDA) has cracked down on banning flavored e-cigarette products. As vaping use…

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Proposed Federal Legislation Intended to Expedite Prior Authorization Approval Process

BY TOG Network Solutions | Apr 15, 2024

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

BY TOG Network Solutions | Apr 02, 2024

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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Prepare for Medicaid Access Changes: What Your Health Plans Need to Know Now

BY TOG Network Solutions | Mar 08, 2024

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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Infectious Disease Cases are Rising: How Can Your Health Care Provider Network Act as a Buffer?

BY TOG Network Solutions | Jan 17, 2024

Estimated Read Time: 5 Minutes Learn how your health care provider network can: Identify community hot spots & engage vulnerable populations. Craft engaging educational content for optimal reach & impact.…

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