Healthcare claims processing is rife with inefficiencies and financial strains marked by operational bottlenecks, rising denial rates and increasing administrative burdens faced by providers, ...

Optum has introduced Optum Real, a real-time AI claims system that offers faster reimbursement by connecting payers and providers in real time. Optum Real provides instant coverage validation through ...

Healthcare technology company Hyphen is aiming to bring social-needs-related organizations into the payment ecosystem with its new platform. The company is launching a new Social Care Claims ...

Providers’ struggles with claims denials have worsened compared with two years ago, according to Experian Health’s 2024 State of Claims survey released on Tuesday. Prior authorizations and missing or ...

Artificial intelligence and algorithms are a part of many businesses these days, including health insurance. It's a conversation that's resurfaced since the killing of UnitedHealthcare CEO Brian ...

Health insurers have used AI to make decisions on medical claims. Now, patients are using the technology to fight denials.

With all the hype around AI, business partners and legal professionals are scrambling to understand, adapt, and possibly implement the rapidly changing technology. From a business perspective, the ...

Humana is expediting its claim review processes and suspending more prior authorization requirements amid the COVID-19 pandemic. To ensure payment is sent to providers as quickly as possible, Humana ...

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher. Economic pressures and declining ...

The targeted killing of UnitedHealthcare CEO Brian Thompson in December became a turning point in the public's growing frustration with the health insurance industry. People began sharing stories ...

The first phase of the interoperability project will focus on Medicare Advantage members, using FHIR and open APIs to automate patient identification and give clinicians the actionable information ...

Don't rush to pay out of pocket if your health insurance denies a test, treatment, or medication your doctor says you need. Consumer Reports says you have a guaranteed right to appeal that decision— ...