Claims Processing

The intent of prior authorization - to make efficient use of health resources - has not worked, says Peter Ax of UpScriptHealth.

Also: SmarterDX launches tools to help hospitals overturn denials in minutes and recover lost revenue.

Also, athenahealth intros athenaOne for Behavioral Health, and Clarify Health empowers payers with AI-driven cost containment tools and quality improvement analytics.

It's already happening: CFOs are getting Teams calls from their "CEO" asking for reports on financial transactions, says ChristianaCare CISO Anahi Santiago ahead of her appearance at the 2024 HIMSS Healthcare Cybersecurity Forum.

Despite a greater ability for healthcare entities to challenge regulatory decrees in court, increased litigation could result in unfavorable court decisions that are harder to fix, healthcare attorneys say.

Beginning this month, Cigna members can connect for urgent care from board-certified doctors without phone or video.

Out-of-the-box generative artificial intelligence capabilities on Health Cloud, specific to provider operations, will be available in October through a new AI use case library.

Dr. Traci Granston, medical director at Cohere, describes how information is extracted in real time, speeding the process to approve or to ensure medical necessity is met.

Also: PatientPay partners to reduce rev cycle friction, two radiology IT rivals join forces and Check Point acquires an AI-powered risk management company.