Claims Processing

Healthy Alliance IPA, led by former ONC deputy Dr. Jacob Reider, will work with MVP Health Care to connect social services and healthcare providers via the Unite Us technology platform. The aim: strengthening community organizations, boosting pop health and reducing costs.

As part of the deal, which involves nonclinical technologies, about 540 health system staff will become Optum employees.

The list of healthcare jobs the AHIMA Foundation program can help fill and upskill is long and varied, including clinical documentation improvement specialists, data analysts, medical and clinical lab techs, privacy and security officers and more.

Digitize.AI's Lia technology uses real-time analytics and machine learning to automatically check for new cases and securely submit them directly to payers.

The CEO says cash raised by the stock offering will help broaden the analytics and data capabilities it can offer its payer and provider customers – and drive innovations in AI, blockchain, robotics and more.

The tool can help health systems optimize submissions and better predict potential issues with claims, the company says, giving recommendations to help mitigate denials before they're submitted.

IaaS and SaaS offerings are enabling payers to run analytics against claims and other data in new ways that enable them to operate more efficiently.

The insurance group says it's supportive of more data sharing, but says CMS' timeline for API-enabled access is too aggressive.

Until November, reimbursement for remote patient monitoring services was a gray area for providers, but the picture is becoming clear.

IDC and Ponemon experts highlight the advantages of storing insurance claims information in the cloud and offer advice about security and data control.