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

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 ...

KNOXVILLE, Tenn. — The University of Tennessee Research Foundation's Accelerate Fund is investing $150,000 in an artificial intelligence startup for processing health care claims. The startup, ...

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 ...

Healthcare CFOs making underpayment analysis a top priority use AI tools to recover millions amid rising Medicare and commercial claim denials.

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher.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

The regulator has found that the insurer failed to provide proper reasons for claim repudiation or for paying a reduced ...

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 ...

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— ...