Claims Processing
In its first year at Medica, HealthRules Promote supported more than 400 configuration projects and yielded an estimated $750,000 cost savings, according to the company.
When Vanderbilt University Medical Center turned over non-anonymized medical records to the state without patient consent, it pitted Tennessee state law against HIPAA and unleashed a federal investigation as well as a class action patient lawsuit.
Payers and providers can prevent overwhelming administrative burdens with machine learning strategies that look at patient needs beyond a single transaction, explained Niall O'Connor, chief technology officer at Cohere Health.
Health Care Service Corporation is using augmented intelligence to accelerate prior authorization – up to 1,400 times faster – and an AI tool that references historical authorizations and claims to authorize treatment "within seconds," the company says.
The study of 1.7 billion clinical notes over a three-year period found an increase in the use of digital tools and copy/paste functionality correlated with longer notes and a decrease in the average time spent writing notes.
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.
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.
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.
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.
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.