Claims Processing

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.

The founder and CEO of Billy, Cody Coonradt, discusses how the company's app, which displays hospital pricing data by location, can help patients and advocates negotiate prices for medical procedures.

Writing to the health secretary and the deputy national security advisor, the lawmaker cited recent cyber hygiene failures by healthcare organizations and asked the agency to propose mandatory minimum cyber standards already under consideration.

Harmony Park Family Medicine also saw turnaround times decrease significantly, with more than half of monthly determinations requiring no authorization – and 70% of prior auth requests sent to Humana being approved instantly.

In its new HTI-2 proposed rule, the Office of the National Coordinator is hoping FHIR-focused interoperability criteria will ignite payers and public health and others to embrace broader information sharing goals.

In a "tour de force" rulemaking, the agency has "harnessed all the tools at ONC's disposal" to advance HHS' nationwide interoperability and patient engagement goals, says National Coordinator Micky Tripathi.

Payers need information for risk adjustment and providers need data to close gaps in care, says Piyush Khanna of CareFirst BCBS.

Sal Lo, CEO of Jorie AI, discusses the company's policy of offering its automated billing and collections product to rural hospitals at a lower price to help them maximize reimbursements and sustain operations.