The healthcare industry's first platform to fully replace manual eligibility interpretation while automating insurance ...

Medicare's new pilot program, WISeR (Wasteful and Inappropriate Service Reduction), is set to revolutionize the decision-making process for coverage of certain procedures by integrating artificial ...

As payers deploy advanced tech to scrutinize claims, health systems like Mercyhealth and WellStar are fighting back with stricter contracts and predictive AI. Over the past several years, the uphill ...

For Neal Shah, the breaking point came during his wife's cancer treatment. He remembers being overwhelmed, surrounded by stacks of hospital bills, denial notices and insurance statements. When he and ...

Insurers’ growing use of AI in coverage decisions has faced scrutiny from some lawmakers concerned that the technology could deny care unfairly, especially in the MA program. UnitedHealth and Humana ...

As health insurers increasingly rely on artificial intelligence to process claims, denials have been on the rise. In 2023, about 73 million Americans on Affordable Care Act plans had their claims for ...

Macy is a writer on the AI Team. She covers how AI is changing daily life and how to make the most of it. This includes writing about consumer AI products and their real-world impact, from ...

Taking a page from the private insurance industry’s playbook, the Trump administration will launch a program next year to find out how much money an artificial intelligence algorithm could save the ...

HealthLeaders 2025 webinars highlighted pivotal shifts in revenue cycle management, demonstrating how leaders are moving from reactive to proactive strategy through AI adoption, enhanced patient ...

In a typical U.S. hospital system, the revenue cycle is under constant pressure. A significant portion of this pressure comes from denied claims, which was estimated to be a $262 billion problem ...