‘AI arms race’ underway as payers, providers jockey for upper hand in claims review
Payers currently have a leg up when using AI to review claims, but providers could soon catch up, experts say....
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Payers currently have a leg up when using AI to review claims, but providers could soon catch up, experts say....
Attorneys argue Khan and two other commissioners are biased against pharmacy benefit managers and should recuse themselves from an ongoing lawsuit...
Only 25% of Humana members will be in plans with four stars or above next year, down from 94% this...
The Commonwealth Fund analyzed the healthcare systems of 10 nations and found the U.S. ranked last in access to care,...
More employers now offer fertility benefits, particularly fertility medications and in vitro fertilization, according to a new report. Article By:...
The rule gives additional teeth to an almost 16-year-old law meant to force health insurers to cover mental health and...
More than 80% of denied requests were overturned when appealed, but few beneficiaries formally questioned the decisions. Article By: Emily...
Insurers cited workforce shortages, hospital consolidation and growing demand for pricey GLP-1 drugs as reasons driving the premium increases for 2025....
The 5th Circuit Court’s decision vacates instructions that arbiters should first consider the qualifying payment amount in deciding payments over contested out-of-network bills. Article...
Cost of cardiovascular conditions is up 33% — “higher than we would expect given medical inflation,” the company said. Article...