Healthcare claims processing is rife with inefficiencies and financial strains marked by operational bottlenecks, rising denial rates and increasing administrative burdens faced by providers, ...

Medical service providers are responsible for billing insurance companies for their patients’ services and procedures. To do so, they must file medical claims as part of the medical billing process.

Optum has introduced Optum Real, a real-time AI claims system that offers faster reimbursement by connecting payers and providers in real time. Optum Real provides instant coverage validation through ...

Healthcare technology company Hyphen is aiming to bring social-needs-related organizations into the payment ecosystem with its new platform. The company is launching a new Social Care Claims ...

Providers’ struggles with claims denials have worsened compared with two years ago, according to Experian Health’s 2024 State of Claims survey released on Tuesday. Prior authorizations and missing or ...

Starting January 1, 2026, California Assembly Bill 3275 (AB 3275) will go into effect, introducing shorter claim reimbursement timelines for health care service plans and health insurers operating in ...

Health care providers are in an acute financial situation. Record-high wages required to attract and retain talent coupled with price inflation not seen since the early 1980s are driving higher costs, ...

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher. Economic pressures and declining ...

With all the hype around AI, business partners and legal professionals are scrambling to understand, adapt, and possibly implement the rapidly changing technology. From a business perspective, the ...

The targeted killing of UnitedHealthcare CEO Brian Thompson in December became a turning point in the public's growing frustration with the health insurance industry. People began sharing stories ...

Health insurers have used AI to make decisions on medical claims. Now, patients are using the technology to fight denials.