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

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 ...

Claim denials are rising due to data inaccuracies, staffing shortages, and outdated technology, with 41% of providers experiencing denial rates of 10% or higher.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

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 ...

The first phase of the interoperability project will focus on Medicare Advantage members, using FHIR and open APIs to automate patient identification and give clinicians the actionable information ...

Many Americans who expect insurers to cover their treatments or procedures end up being denied vital care. Americans, many of whom harbor long-simmering anger over our health care system, vocalized ...

Don't rush to pay out of pocket if your health insurance denies a test, treatment, or medication your doctor says you need. Consumer Reports says you have a guaranteed right to appeal that decision— ...

Democrats are concerned about the upcoming expiration of expanded Affordable Care Act subsidies, which could cause premiums to rise significantly. Republicans argue Democrats want to fund health care ...