The model will leverage AI and machine learning for prior authorization of services vulnerable to fraud or inappropriate use, ...

According to CMS, they should review Medicare Summary Notices and Explanation of Benefits for any unfamiliar charges or services, and report any suspicious activity to 1-800-MEDICARE (1-800-633-4227) ...

Home health agencies are facing a proposed 6.4% decrease in Medicare payments in 2026, compared to 2025.

Data gives insights but that information works best when it can be seen by a customer service representative during a patient interaction, says Casey Williams, senior VP of patient engagement at ...

Health and Human Services Secretary Robert F. Kennedy Jr. has said the United States will cease making contributions to Gavi, ...

Clinician frustration also remains a significant barrier to adoption. CIOs reported that the top complaints about AI tools ...

Health insurers, including Humana, Elevance and CVS Health, have committed to a number of actions meant to simplify and ...

A telehealth provision in its bill makes permanent first-dollar coverage for High-Deductible Health Plan-Health Savings Accounts, says ATA.

In the mid revenue cycle, AI makes more accurate and efficient decisions, ensuring hospitals get reimbursed the amount ...

To achieve its goal, Humana told investors it's set several targets, including increasing preventative care visits by 20% ...

Almost three-quarters of respondents say they're concerned specifically about revenue growth and operating profitability.

AdvancedMD and NGA Healthcare have partnered to help independent medical practices get higher reimbursement rates from payers ...