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Claims Processing

By Andrea Fox | 11:28 am | June 30, 2023
The company says it will infuse generative AI and large language models across the breadth of its AwareCDI product suite to streamline physician administrative burdens and to help hospitals and health systems capture more earned revenue.
By Andrea Fox | 09:44 am | June 21, 2023
Dr. Don Rucker, now chief strategy officer with 1upHealth, weighs in on where TEFCA is headed and his fundamental concerns about veering away from the way the rest of industry computes.
By Andrea Fox | 10:55 am | June 07, 2023
LeanTaaS rolls out an AI autopilot in beta for its iQueue operations platforms, Carbon Health launches charting with artificial intelligence in its EHR and Clarify Health opens up Clara, its AI copilot, to select healthcare organizations.
By Andrea Fox | 11:51 am | May 12, 2023
Femtech developer Aspira Women's Health signs with Dana Farber to license a biomarker-based ovarian cancer diagnostic, a Madrona Venture Labs spin-out adds GPT-enabled virtual agents to billing automation and Dave, an LLM oncology tool, is born.
By Andrea Fox | 09:06 am | May 01, 2023
Point32Health, the parent organization of Harvard Pilgrim Health Care and other health insurance plans, has taken HPHC systems offline, and providers are unable to confirm patient eligibility.
By Andrea Fox | 12:43 pm | April 12, 2023
The National Council for Prescription Drug Programs chose the company for its prescriber database because of "its national coverage, profile depth, flexibility and integrity," the council's president and CEO said.
By Andrea Fox | 09:14 am | April 07, 2023
The integration could help providers and payers that use the TriZetto platform to enhance revenue growth and streamline claims management, while improved interoperability elevates care quality.
By Susan Morse | 12:58 pm | March 28, 2023
 CMS has released a proposed rule to speed up prior authorization approval.
By Andrea Fox | 12:49 pm | March 23, 2023
There's been a softening of healthcare organizations' confidence in the vendor, researchers say, with customers expressing concerns about a post-acquisition roadmap and dissatisfaction with communication around the RevElate RCM platform.
By Bill Siwicki | 12:20 pm | March 03, 2023
What does 2023 hold in store for managing and improving electronic health records – and what's next for what appears to be a market landscape that's quickly consolidating?