By Pamela J. Gallagher – The emergence of artificial intelligence is the topic on every healthcare leader’s mind. In many ways, though, AI is old news to those of us in healthcare finance. I can say from experience that once an AI technology comes onto the scene, there is no stopping it. AI is here to stay.
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By David Burda – Accuracy is a pillar of healthcare consumerism. It’s the most important pillar. If we want patients and members to make informed decisions about their medical care and their health insurance, they need accurate information to make the right choices for them.
Latest news being reported on payers and the health insurance industry including news from CVS Health, IBX, UnitedHealthcare, Humana, CareSource, Cigna, AHIP, Superior HealthPlan and more.
By Jane Austen – Healthcare revenue cycles struggle with claim denials. Denial management investigates each denial, determines why it was denied, and determines how to fix the problem and reduce future denials. Sophisticated and robust automation, designed to meet providers’ needs and achieved through AI and ML, empowers organizations to…
By Deepali Narula – A three-pronged approach hospitals should follow to navigate denials, optimize revenue and mitigating staffing shortages Three out of four hospitals in the U.S. have experienced revenue cycle issues since the COVID-19 pandemic.
By Dmitrii Evstiukhin – Medical insurance claims processes create mounds of documents that often get backlogged or denied, slowing business operations and reducing efficiency. Now AI solutions are dramatically accelerating medical claims processing while reducing errors and enhancing overall efficiency.
Latest news being reported on payers and the health insurance industry including news from Oscar Health, AHIP, Independence Blue Cross, Independence Health Group, CVS Health, UnitedHealth Group, Humana, and more.
By David Burda – To answer the question in the headline, which I haven’t seen anywhere yet, is yes. Yes they did. That’s according to the latest annual March report to Congress from the Medicare Payment Advisory Commission, or MedPAC.
By Tom Dorsett – As of April 2023, the FDA has approved the use of 40 “biosimilars”, which are a less expensive version of an advanced “biologic” medication. The rise of biosimilars is a major source of excitement as a way to control rising drug costs. But is the fervor warranted?