What You Should Know: - Today, healthcare automation company Olive, today announced a $400M in funding round led by Vista Equity Partners with additional investment from the Base10 Partners Advancement Initiative. Olive, a provider of AI powered workforce purpose-built for healthcare, has now secured $832 million in financing since March 2020, and $902 million since the company’s inception in 2012 bringing the company’s total valuation to $4 billion. - The company plans to use
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4 Quick Tips for Getting COVID-19 Claims Paid Promptly
As the COVID-19 pandemic has gripped the world, many providers have adopted an all-hands-on-deck approach and mentality for treating COVID-19 patients, stretching their resources to the breaking point. We have heard about the frontline heroes who have sacrificed their own health and safety to treat patients and, in less-fortunate scenarios, comfort patients in their last moments as they were quarantined from loved ones. What has been less recognized is the work and sacrifice
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Gleaning Insights for COVID-19: Why Claims and Clinical Data Matter
Healthcare organizations continue to rely heavily on data analytics to try to improve COVID-19 outcomes and public health. Since the novel coronavirus became widespread in the U.S., healthcare data scientists have leveraged clinical and claims data to pinpoint which underlying conditions put patients at higher risk of complications from COVID-19. Health systems are mining clinical data to predict surges in COVID-19 cases and looking at key factors—including increases in hospital website traffic,
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Hospital Sustainability Demands that Revenue Integrity Move Front and Center
Razor-thin operational margins coupled with substantial and ongoing losses related to COVID-19 are culminating in a perfect storm of bottom-line issues for U.S. hospitals and health systems. A study commissioned by the American Hospital Association (AHA) found that the median hospital margin overall was just 3.5% pre-pandemic, and projected margins will stay in the red for at least half of the nation’s hospitals for the remainder of 2020. The reality is that an increase in
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Verisk Acquires MSP Compliance Provider Franco Signor for $160M
What You Should Know: - Verisk acquires Franco Signor, a Bradenton, FL-based full-service provider of MSP compliance software and services for $160M. - Property/casualty insurers, self-insureds, and TPAs
will benefit from the most comprehensive suite of fully integrated Medicare
compliance solutions and greater access to the nation’s top Medicare experts. Verisk, a data
analytics provider, announced today that it has acquired
Franco Signor, a Medicare Secondary
Payer (MSP) service
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HealthEdge Acquires Payment Integrity Solution The Burgess Group
What You Should Know: - HealthEdge Software announces the acquisition of The Burgess
Group, LLC (“Burgess”), an innovative payment integrity software company
focused on improving healthcare payment operations for an undisclosed sum. - The strategic acquisition will boost Health Edge’s position in
the payment integrity market and extends best-in-class claims processing to
include software-driven payment integrity - Burgess’ product, Burgess
Source®, is the first solution to natively
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Why Government-Supported Health Plans Must Make Encounter Submissions A Top Priority in 2020
Encounter data such as diagnosed clinical conditions and services, or items delivered to healthcare consumers to treat these conditions is the key to success for all healthcare organizations participating within the government space. Whether doctors or hospitals are submitting data for medical services rendered under Medicare Advantage, the Affordable Care Act’s state exchanges or Medicaid, encounter data is used for payment reimbursement and reconciliation between the health plan and the
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Mastercard Unveils Suite of Healthcare Solutions to Detect Fraud & Protect Health Data
- Mastercard unveils new suite of healthcare solutions to move beyond cards and reimagining how its technology and capabilities can benefit the healthcare ecosystem. - Mastercard Healthcare Solutions will develop and provide the tools needed to protect detect fraud, waste, and abuse, capture more revenue, and protect patient health data.Mastercard today unveiled Mastercard Healthcare Solutions, a new suite of products dedicated to helping healthcare partners detect fraud, waste, and abuse,
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Change Healthcare: Applying AI Could Identify Up to 35% of Denials Prior to Submission
Change Healthcare AI can help providers identify problem claims and prevent denials before they happen, avoiding costly rework, delays, and improving revenue flow.Today Change Healthcare announced that it has applied its Claims Lifecycle Artificial Intelligence (AI) technology to its claims management suite with the introduction of Assurance Reimbursement Management™ Denial Propensity Scoring and Revenue Performance Advisor Denial Prevention. With performance enhanced by Claims Lifecycle AI,
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Change Healthcare Unveils Claims Lifecycle Artificial Intelligence
Change Healthcare today announced Claims Lifecycle Artificial Intelligence, a new capability being integrated into the company’s Intelligent Healthcare Network and financial solutions, to help providers and payers optimize the entire claims processing lifecycle.Claims Lifecycle AI OverviewThis Change Healthcare Claims Lifecycle AI service is trained on more than 500 million service lines making up over 205 million unique claims that touch $268 billion in charges. The service leverages the
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