As health insurers increasingly rely on artificial intelligence to process claims, denials have been on the rise. In 2023, about 73 million Americans on Affordable Care Act plans had their claims for ...

Lightbeam Health Solutions, the proven, AI-enabled solutions and services leader in population health management, announces that Integrity Health, a New Jersey and Pennsylvania-based healthcare ...

The CMS has launched a pilot program that is based on an industry-standard application programming interface that gives providers access to patients’ claims data, according to a July 30 news release.

When patients are prescribed complex therapies — like specialty drugs, cell and gene treatments, or high-cost biologics — the path to treatment is rarely straightforward. Filling a prescription can ...

For many US health systems, international patient claims represent a deceptively small portion of total revenue, often less than 2 percent. This financial class, however, routinely carries some of the ...

A predictive model identifies RA patients at risk of D2T-RA, using machine learning and real-world data for early intervention. Patient-reported outcomes, such as pain and fatigue, are stronger ...