Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

The partnership combines Abridge’s conversational AI platform with Availity’s FHIR-native Intelligent Utilization Management ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...

Medicare will significantly expand the use of prior authorization (PA) and post-service review for select services beginning next year, and private contractors will be permitted to use artificial ...