Depending upon a provider’s strategic goals, KPIs are used for any number of reasons, from negotiating better contractual terms to tracking negative trends and identifying problem areas. Here are some suggestions.

• A Peek Into One Provider’s KPIs
• David Hammer's Managed Care KPIs 
• Talk about KPIs on  the message board 

Although Medicare’s private fee-for-service option was created in 1997, only in the past few years have health plans that fall into this category experienced rapid growth. What's the future of the plans?

• The Doctor Fix Bill: Going Back to the Beginning
• Kaiser Family Foundation Medicare Advantage Fact Sheet 
• MedPAC's Report on the Medicare Advantage Program
• Talk about Private Fee-for-Service Plans on  the message board 

Looking out for their own bottom lines, payers issue denials on payment of an insurance claim for a host of reasons, from a lack of medical necessity and preauthorization to inaccurate coding and duplicate claims.

• Is it worth it to invest in denial prevention?

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