Daffodil Health Secures $16.3M for Health Plan Administration Platform
Daffodil’s Series A round was led by Flare Capital Partners, with participation from LRVHealth and Maverick Ventures.
Alaffia Health Snags $55M for AI Engine Tackling Healthcare’s Waste Problem
As providers continue to adopt AI in droves, payers are under pressure to modernize their own administrative operations. Alaffia Health says its clinically grounded AI platform can help health plans reduce waste and risk, a bet investors backed this week with a $55 million Series B funding round.
The Power of One: Redefining Healthcare with an AI-Driven Unified Platform
In a landscape where complexity has long been the norm, the power of one lies not just in unification, but in intelligence and automation.
New Entity Aims to Help Payers Improve Payment Integrity
A private equity firm announced the merger of three assets that can reduce payers's headaches when it comes to making sure that provider-submitted claims are accurate. In turn providers can get paid quickly.
Labor Department Sues UnitedHealth Group Over ‘Thousands’ of Claims Denials
The Labor Department recently sued UnitedHealth Group subsidiary UMR, alleging that it wrongfully denied claims for emergency room services and urinary drug screenings since 2015. UMR did not determine the medical necessity of the claims, denying them “based solely on diagnosis codes and not applying a prudent layperson standard," according to the complaint.
How next-generation automation technology can improve healthcare revenue management
The revenue cycle is incredibly complex due to shifting payer requirements, continuous regulatory compliance and coding updates, and emerging and evolving payment models. That complexity increases the administrative burden and drives up cost for providers.
How providers can win the tug-of-war with payers over denials
In this complex and rapidly changing claims denial environment, providers must take a proactive approach to stay ahead of the game. Here's what providers can do to successfully navigate the audit landscape.
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MedCity News Pivot Podcast: How Emergency Departments Are Using Real-Time Data to Improve Outcomes
How can AI benefit and improve patient outcome in the emergency department? Watch the latest episode to find out.
Blue Shield of California, Google Cloud to develop real-time claims processing platform
The companies will build their claims processing platform on Google Cloud's infrastructure, leveraging artificial intelligence and machine learning capabilities. The goal of the collaboration is to improve patient and provider experience and reduce spending on administrative processes.