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 ...

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, ...

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

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 ...

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher.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 regulator has found that the insurer failed to provide proper reasons for claim repudiation or for paying a reduced ...

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 ...

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— ...