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 ...

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 ...

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

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher.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

Oracle launches Oracle Health Clinical Data Exchange to automate medical claims and enhance provider-payer data sharing. Built on Oracle Cloud Infrastructure, it reduces administrative costs, improves ...

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 ...

As states strive to curb health insurers' use of artificial intelligence, patients and doctors are arming themselves with AI tools to fight claims denials, prior authorizations and soaring medical ...

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— ...