
Better AI + Correct Provider Guidance = Fewer Denials
How do we tip the scale to lower the rate of denials? While AI has been the initial decision-maker for years, it must become better trained. And to do that, it needs help.
How do we tip the scale to lower the rate of denials? While AI has been the initial decision-maker for years, it must become better trained. And to do that, it needs help.
There are a number of important ways AI will impact patients, providers and pharmacies in the coming year. They break down into three key areas.
Both providers and payers face challenges and understanding the requirements and needs of each stakeholder has the potential to lower the temperature of the current rhetoric.
Healthcare consumers are increasingly turning to the internet to research their care options, and provider and payer websites are among their top choices for information, according to a new survey of 1,000 U.S. adults. Over half of the respondents said they would use a provider or payer website to search for a new doctor.
In a wide-ranging interview, Dr. Scott Weingarten, the payer's inaugural chief innovation officer, discussed his priorities in his new role, including the new payer-agnostic geriatric primary care group he will help launch.
The HHS' information blocking rule goes into effect Monday, and for nearly a year, providers and IT vendors have been racing to prepare. But they have faced several hurdles along the way, including figuring out how to handle scenarios that could make them non-compliant.
The health system and payer are joining forces to offer Medicare Advantage patients access to Mercy's telehealth center. They also plan to implement a value-based payment model, tying reimbursement for Mercy clinicians to care quality measures.