Illinois Association of Medicaid Health Plans (IAMHP)’s Post

Unlocking patient access comes with its challenges. 🧗♂️ Nearly all specialty medications require Prior Authorizations (PAs), while 39% involve step therapies creating barriers for both prescribers and patients . PAs require Healthcare Professionals (HCPs) to engage in a meticulous and time-consuming process of obtaining approval from insurance providers which places a high administrative burden on HCPs. This ultimately impacts patient access through care delays to needed medications. These numbers shed light on the intricacies of the prescription journey, posing challenges for both HCPs and patients alike. As a healthcare community we should continue to work towards improved patient access to critical medications. If you’re interested in learning more about how we make prescribing easier, check out https://hubs.li/Q02g4YxH0. #PatientAccess #HealthcareTechnology #MarketAccess #DigitalHealth #Medicine

4.1% improvement in RX pick up rates! YES! 👏🏼 Let us help you drive great member engagement campaigns that directly impact key Stars metrics and measurable results. Take a read ⬇️ let’s talk! #cx #stars #digitaltransformation #drips

Risant Health recently purchased Geisinger in PA. Geisinger is primarily a value-based care provider, but also has ~100,000 Medicare Advantage members. Most of which look to be in the more "rural" areas of PA. For more info on the acquisition see the article linked in the first comment below. It sounds like Risant is interested in purchasing more value-based care providers. Will be interesting to see if those also include MA members. ___ Give me a follow. I post Medicare Market Insights daily!

Medicare compliance in therapy can be complex so let's break down each elements that are essential for providing high-quality, effective therapy while ensuring compliance with Medicare regulations. 1. Dx Codes - Accurate coding ensures proper billing and avoids claim denials. 2. Patient History - Comprehensive documentation aids in creating effective treatment plans. 3. Plan of Care (POC) - Regularly update POCs to improve patient outcomes. 4. ADLs & Functional Deficits - Tailor interventions based on detailed assessments. 5. Goal Tracking & Billing - Adhere to the 8-minute rule for precise billing. 6. Cap Management - Navigate the Auto KX Modifier and stay within Medicare caps. 7. Medication Management - Keep track of medications to ensure patient safety. Mastering these areas, can help you focus on improving patient outcomes and maintaining a sustainable practice. Simplify your practice and stay Medicare compliant with HelloNote! Share this with your fellow practitioners for a more informed and compliant therapy practice. #MedicareCompliance #TherapyPractice #PhysicalTherapy #OccupationalTherapy #SpeechTherapy #Healthcare #EMR #ElectronicMedicalRecords #Billing #Documentation #PatientCare #HelloNote #HelloNoteEMR

🔍 Dive into Medigap for Comprehensive Coverage! ✨ Did you know that Original Medicare might leave gaps in coverage? That's where Medigap policies come in! These additional plans can be your shield, covering expenses like copayments and deductibles that Medicare doesn't fully cover. 🛡️ Take control of your healthcare expenses and explore Medigap for comprehensive coverage. Research these supplemental plans to bridge the gaps and secure your financial well-being. It's a smart step towards ensuring you're fully protected! 💊  Don't let unexpected healthcare costs catch you off guard. Investigate Medigap policies for that extra layer of coverage and peace of mind! 💡  For more information contact us at +1 (602) 551-7207 #Medigap #SupplementalCoverage #HealthcareInsights #Medigap #SupplementalInsurance 🔍

We've all been following the difficulties resulting from the cyberattack impacting Change Healthcare/Optum, especially their retail pharmacy and provider partners, who are unable to adjudicate or submit claims, but also their other lines of business. If you're a health plan, State Medicaid Agency or health plan sponsor and Change's down-time is resulting in your pharmacy benefit services not being completed, we at SevenRx might be able to help. We can stand up an instance of our pharmacy prior authorization product (7R_PA), our Case Manager (7Rx_Case Manager), our retro-Drug Utilization Review product 7Rx_rDUR, our Maximum Allowable Cost product (7Rx_MAC) and others to ensure that health plans can provide urgent clinical services to their lives under management. Please reach out to us by visiting our website below to see how we can help: https://sevenrx.com

Healthcare payers: What would a 4.1% improvement to prescription pick-up rate mean to your organization? One of the biggest challenges with medication adherence is not just that the prescription gets filled, but that it gets picked up. We're seeing great results applying AI-backed conversational outreach to this challenge. We helped a major payer realize a 4.1% improvement in pick-up rate. That represents over 8,500 seniors getting their medications who otherwise wouldn’t have. Need help getting your members engaged? Learn how Drips gets your members talking: https://ow.ly/Aczv50Qsjzl #ItsAllAboutHowYouSayIt #healthcare

Say Goodbye to waiting rooms for good! Your Revolt Healthcare Network membership gives you 24/7 virtual access to US-based doctors & counselors via phone or video chat through your patient portal! No more waiting weeks for appointments or sitting for hours in crowded waiting rooms. Get the care you need, on your schedule. 𝐒𝐭𝐚𝐫𝐭𝐢𝐧𝐠 𝐚𝐭 𝐣𝐮𝐬𝐭 $𝟑𝟔/𝐦𝐨𝐧𝐭𝐡, 𝐲𝐨𝐮𝐫 𝐌𝐞𝐦𝐛𝐞𝐫𝐬𝐡𝐢𝐩 𝐚𝐥𝐬𝐨 𝐜𝐨𝐦𝐞𝐬 𝐰𝐢𝐭𝐡: ✅ AT COST Prescriptions DELIVERED to your door ✅ FREE Out-patient Quest Labs  ✅ EXPERT medical billing and procedure pricing support (our billing specialists will negotiate your predatory bills for you - or even get some BILLS ERASED ENTIRELY!!) This is not insurance: there’s no copay, deductible, or red-tape! Your low monthly fee covers your care - it’s that simple! 𝐇𝐞𝐚𝐥𝐭𝐡𝐜𝐚𝐫𝐞 𝐀𝐬 𝐈𝐭 𝐒𝐡𝐨𝐮𝐥𝐝 𝐁𝐞. 𝐒𝐢𝐠𝐧 𝐔𝐩 𝐓𝐨𝐝𝐚𝐲 𝐭𝐨 𝐒𝐭𝐚𝐫𝐭 𝐒𝐚𝐯𝐢𝐧𝐠 𝐍𝐨𝐰! 𝐡𝐭𝐭𝐩𝐬://𝐫𝐞𝐯𝐨𝐥𝐭.𝐡𝐞𝐚𝐥𝐭𝐡/𝐧𝐞𝐭𝐰𝐨𝐫𝐤-𝐬𝐚𝐯𝐢𝐧𝐠𝐬 #revolthealthcarenetwork #prescriptions #rx #medicare #healthcare #revolthealthcarealliance

Collaboration between healthcare providers and payers is instrumental in navigating the complexities of medical necessity criteria. By fostering a cooperative environment, both parties can work together to ensure that medical decisions align with the best interests of the patient. https://lnkd.in/enecnuQb #medicalnecessity #MNC #providers

It can be challenging to adhere to the many rules and regulations of incident-to billing. However, practices that do not use incident-to billing could overlook opportunities to use NPPs more efficiently and may potentially forgo revenue their practice is eligible for under payer rules. Watch our recorded webinar to learn more about incident-to billing: https://bit.ly/4a0k2lh #ModMed #healthcare #healthtech