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Insurers pressed to send patient coverage information to providers
Modern Healthcare

Health insurers face a new requirement to rapidly communicate electronically with healthcare providers whether a patient has insurance coverage, plus what his or her co-payment split will be for a given visit or procedure, and how much that patient will have to pay under his or her deductibles and out-of-pocket limits.

Now the CMS, an anonymous healthcare provider and a health IT consultant have teamed up to help narrow the gap between those federal requirements for electronic handling of queries about a patient’s health insurance coverage and the rules’ implementation in actual practice.