Tag: Out of Network Medical Claims

Expion Health is pleased to announce our strategic partnership with HUB International, which was launched at HUB’s Clinical and Pharmacy Conference. As a preferred partner, Expion Health will provide expertise in medical bill review, independent reviews, and actionable insights for strategic pharmaceutical initiatives, complemented our powerful, award-winning ExpionIQ analytics. Nick Stone, SVP, Medical Cost Containment … Expion Health Announces Strategic Partnership with HUB International

In the changing landscape out-of-network (OON) medical claims, health plans & TPAs face the dual challenge of managing costs while ensuring fairness and transparency. A recent New York Times article spotlighting practices by certain industry players has intensified concerns regarding the management of OON claims. Such revelations underscore the importance of adopting business practices that … Navigating Shifting Market Expectations: Enhancing OON Claim Repricing Fairness and Transparency

A central theme emerged, at the HCAA Executive Forum: the imperative for TPAs to evolve as a fiduciary-like partner for their groups and their employees. In this dynamic landscape, the call for transparency and control in medical claims and administrative costs has never been louder or clearer. A New Paradigm for TPAs In the face … Harnessing Transparency and Control: Key Takeaways from the HCAA Executive Forum from Expion Health

Calculating accurate QPAs is difficult and mistakes can be costly and create compliance risks. Here’s what to do.