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The Latest from Exponent Health
NSA Minute: Impact of Legal Challenges
Legal challenges to the No Surprises Act (NSA) continue to arise with six lawsuits brought forth so far. One lawsuit challenging the constitutionality has failed, but challenges to the regulations used to enforce the statute have continued to erode timely decisions in the independent dispute resolution (IDR) process. Another is challenging the QPA methodology around … NSA Minute: Impact of Legal Challenges
NSA Minute: Hospitals’ Financial Strategy
At the end of 2022, half of hospitals are in the red — putting pressure on hospitals to look for new opportunities to increase revenue. This year, OIG added to the pressure with transparency in coverage enforcement and by looking at hospitals seeking to obtain bad debt recoveries from CMS. All of this is compounded … NSA Minute: Hospitals’ Financial Strategy
NSA Minute: Unexpected Scenarios
As we follow the impact of NSA, we continue to see unexpected scenarios occur. For example, with out-of-network at an in-network facility or even emergency care, we assume this excludes office visits. However, recently it has been shown that there are unique instances where office visits could fall under NSA around radiology and clinical lab. … NSA Minute: Unexpected Scenarios
NSA Minute: Eye Opening IDR Statistics
The recent No Surprises Act’s (NSA) report from HHS, Department of Labor, and Department of the Treasury presented eye-opening statistics about the impact and challenges of independent dispute resolution (IDR). Harnessing the power of our NSA claims processing technology, we are helping clients navigate these challenges by calculating defensible QPAs, identifying claims that are ineligible for IDR, … NSA Minute: Eye Opening IDR Statistics
NSA Minute: Separating NSA and Post-Stabilization Codes
As our hearts and prayers go out to Damar Hamlin and his family for a speedy recovery after his on-field medical emergency, we are reminded of the complexities of emergency care, especially if ongoing care is needed. Even after the immediate crisis has passed, post-stabilization care may still be needed. The No Surprises Act has been instrumental … NSA Minute: Separating NSA and Post-Stabilization Codes
Don’t Risk It: QPA Calculation
Calculating accurate QPAs is difficult and mistakes can be costly and create compliance risks. Here’s what to do.
The Impact of Humira Biosimilars: 5 Factors That Will Reduce Payer Costs
The use of biosimilar products in lieu of originator biologic products has been a hot topic of discussion since the first FDA approval of Zarxio (a biosimilar for Neupogen) in 2015. Since then over 30 new biosimilars have been FDA approved but the biosimilar market hasn’t taken off as expected. The slower than expected uptake … The Impact of Humira Biosimilars: 5 Factors That Will Reduce Payer Costs
The biologics market could see some significant changes with the current and upcoming interchangeability approvals of several biosimilar products. Let’s dive into what biosimilars are and the importance of interchangeability. What is a biosimilar?A biosimilar is a potential alternative for an existing FDA-approved biologic. They are highly similar (can have minor differences in inactive components) … Biosimilars 101
Exponent Health Wins Best Tech For Good
Tech in Motion has named Exponent Health as Chicago’s Best Tech for Good in this year’s Timmy Awards, recognizing the top workplaces for tech professionals across North America. Exponent Health was chosen by other members of the tech industry in Chicago for utilizing tech to help tackle today’s most pressing social, global and ecological challenges, … Exponent Health Wins Best Tech For Good
Exponent Health Name Top 100 Healthcare Technology Companies
Exponent Health has been named one of the Top 100 Healthcare Technology Companies for 2022 by The Healthcare Technology Report. The honorees represent some of the best companies in the healthcare technology space across a range of specialties including genomics, pharmaceuticals, analytics, and consumer healthtech. These companies are changing the face of the industry and impacting … Exponent Health Name Top 100 Healthcare Technology Companies
