Claims Processing
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.
The National Council for Prescription Drug Programs chose the company for its prescriber database because of "its national coverage, profile depth, flexibility and integrity," the council's president and CEO said.
The integration could help providers and payers that use the TriZetto platform to enhance revenue growth and streamline claims management, while improved interoperability elevates care quality.
CMS has released a proposed rule to speed up prior authorization approval.
