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  • The Missing 1 Percent
    The Missing 1 Percent A discussion of insurance claims processing and payment systems, and how to achieve ... achieve the minimum possible number of errors. Audits;Claims processing;Claims review;Data quality; ...

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    • Authors: Jim Del Vecchio
    • Date: May 2010
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Long-Term Care News
    • Topics: Health & Disability>Health information technology; Health & Disability>Electronic medical record
  • The ACA’s Medical Loss Ratio Provisions: Looking Back
    The ACA’s Medical Loss Ratio Provisions: Looking Back The ACA’s Medical Loss Ratio Provisions Patient ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Rowen Bell
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Wall of Comments
    Wall of Comments A compilation of feedback from actuaries in the Health Section of the affects of the ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Society of Actuaries
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • The Role of the Affordable Care Act in Payment Reform
    The Role of the Affordable Care Act in Payment Reform Affordable Care Act and Payment Reform Patient ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Juliet Michelle Spector
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Behind Clinical Integration
    activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency ... infrastructure of the health care system. This article discusses relevance and implication of regulatory ...

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    • Authors: Steven Tutewohl
    • Date: May 2010
    • Competency: External Forces & Industry Knowledge>External forces and business performance; Professional Values>Public interest representation; Strategic Insight and Integration>Effective decision-making
    • Publication Name: Health Watch
    • Topics: Health & Disability>Health information technology; Public Policy; Technology & Applications>Data warehousing; Health & Disability>Electronic medical record
  • Taxes and Fees Introduced by the ACA
    Taxes and Fees Introduced by the ACA Taxes and Fees Introduced by the ACA Patient Protection and Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Michael Gaal
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Final Thoughts
    Final Thoughts Wrap-up of publication and thank-yous. Patient Protection and Affordable Care Act= PPACA=Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Valerie Nelson
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance
  • A Regulatory Perspective on Rate Review Before and After the Affordable Care Act
    and After the Affordable Care Act A Regulatory Perspective on Rate Review Before and After the Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Annette James
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • The Individual Market and ACA Products: Starting from First Actuarial Principals
    The Individual Market and ACA Products: Starting from First Actuarial Principals Individual Market and ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Kurt Wrobel
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability
  • Surplus and the ACA
    Surplus and the ACA Surplus and the ACA Patient Protection and Affordable Care Act= PPACA=Affordable ... PPACA=Affordable Care Act;Health care reform;Health insurance;Medical Loss Ratio=MLR;Accountable care organizations= ...

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    • Authors: Daniel Pribe
    • Date: Aug 2015
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance
    • Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability