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The landscape of healthcare management has shifted dramatically in the years following the coronavirus pandemic. Some practices have fallen by the wayside, while others have gained newfound importance. One area that has become increasingly vital for large employer health plans, particularly...

Not long ago, many self-funded medical plans conducted claim audits to meet regulatory requirements, often relying on random samples. If these medical claim auditing practices had remained unchanged during the pandemic, there would have been less scrutiny of claim payments, given the incredibly...

The aftermath of the coronavirus pandemic has led to a significant need for rebuilding and reassessing various sectors, including the medical and pharmacy benefit plans of large corporate and nonprofit employers. To navigate this complicated landscape, these organizations increasingly seek...