A fully insured business will shop around with different health insurance companies for the best value, including a good network. However, self-funded health plans — which are growing in popularity — ...

Virtual care and health navigation company Included Health, launched a new artificial intelligence-powered tool aimed at ...

The Centers for Medicare and Medicaid Services (CMS) today removed the requirement that health plans offered on the ACA exchanges operate with a provider network. The decision opens the individual ...

Up-to-date provider network directories enhance patient satisfaction and reduce operational costs. Yet health plans are facing several challenges to attract, retain and manage their provider networks ...

Building and managing healthcare provider networks can be complicated — especially because provider directories must be kept compliant and up to date. Members of your provider onboarding and ...

Many plans sold on the health insurance marketplaces offer a tradeoff: lower premiums in exchange for limited networks of providers. But consumers who opt for a narrow network plan with the idea that ...

Member benefits are designed to promote the use of network providers, including lower copayments, reduced out-of-pocket costs, and comprehensive coverage for in-network services. Members also enjoy ...

Medicare Preferred Provider Organizations (PPOs) are one type of Medicare Advantage (Medicare Part C) plan. With PPOs, you are not limited to receiving services from in-network providers. However, you ...

Mental health services are up to six times more likely than general medical services to be delivered by an out-of-network provider, in part because many psychiatrists do not accept commercial ...

Provider network intelligence (PNI) technology represents a revolutionary approach to network management that combines artificial intelligence, real-time data analytics and predictive modeling to ...

The percentage of patients receiving in-network care increased nationally by 7% across all medical specialties from 2019 to 2023, according to a new report. Overall, the national percentage of ...