What You Should Know:
- Hospitals across the country are facing an ever-increasing onslaught of claims denials from insurance companies, with denials up 20.2% in 2023, according to the American Hospital Association. These denials – triggered by AI and often error-prone – cost hospitals $20 billion a year in administrative bloat and reduce patients’ access to quality care.
- To help hospitals fight back, Cofactor AI today introduced a new first-of-its-kind AI-powered
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Healthcare Claims
Tassat, Veuu Partner to Streamline Healthcare Claims and Payments with Blockchain
What You Should Know:
- Tassat Group, Inc., the leading provider of private permissioned blockchain-based real-time settlement solutions, today announced its strategic partnership with Veuu, an innovative AI-powered healthcare fintech company, to improve the inefficiencies and opaqueness plaguing the healthcare claims and payment process.
- Leveraging Tassat’s smart contract capabilities, this collaboration empowers Veuu with a solution to provide greater confidence in the traceability
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Q/A: Vim CEO Talks Solving the Rising Tide of Healthcare Claim Denials
The U.S. healthcare system is grappling with a surge in claim denials and prior authorization requirements, creating significant challenges for both providers and patients. To shed light on this pressing issue, we spoke with Oron Afek, CEO of Vim, a company that assists over 20,000 providers and 80% of the largest U.S. payers with prior authorizations.
In this interview, Oron Afek provides valuable insights into the challenges and potential solutions related to claim denials and prior
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FinThrive Integrates with Oracle Health Patient Accounting for Claim Management
What You Should Know:
- Enhanced Claims Management: FinThrive and Oracle Health have completed a collaborative development effort, now certified, that seamlessly integrates FinThrive’s claims management solution with Oracle Health Patient Accounting, enhancing claims processing for Oracle Health customers.
- Streamlined API Integration: This integration utilizes API technology to deliver a unified login experience and improve real-time claim edits, enabling Oracle Health users to
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Claimable Launches AI-Powered Appeals Platform to Fight Unjust Healthcare Denials
What You Should Know:
- Claimable, a healthcare technology innovator, is taking on the pervasive issue of healthcare claim denials with the launch of its AI-powered appeals platform.
- This solution leverages advanced AI to analyze clinical research, policy details, appeals data, and patients' individual medical circumstances to generate and submit customized appeals in mere minutes.
Combating a Broken System
The U.S. healthcare system is plagued by an alarming rate of
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Zelis Unveils New In-Network Pricing Solution for Streamlined Claim Processing
What You Should Know:
Zelis, a leader in healthcare technology solutions, has announced its newest weapon in the fight against opaque claim pricing: In-Network Pricing and Contract Modeling. This comprehensive solution empowers health plans to understand and manage claim pricing proactively, leading to more accurate cost estimates and improved financial control.
A Complete Claim Pricing Suite: Precision and Transparency
In-Network Pricing and Contract Modeling joins Zelis' existing
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RapidClaims Emerges from Stealth with $3.1M to Tackle Healthcare Claim Denials with AI
What You Should Know:
- RapidClaims, a healthcare technology startup focused on automating medical coding and reducing claim denials, has officially exited stealth mode after securing a $3.1M seed funding round. The seed round was led by Together Fund, a $250 million global SaaS fund, with participation from Better Capital, Neon Fund, Peercheque, DeVC with angels and advisors coming from prominent US healthcare organizations including Oscar Benavidez (Executive Director, Mass General), Ankit
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FWA Is Increasing. Healthcare Costs Are Spiraling. Now There’s A New Generation Of AI Technology To Take Back Control
In 2020, the Department of Justice estimated that fraudulent, wasteful, and abusive (FWA) billing practices account for more than $100 billion of the nation’s healthcare expenditures.1 Today, the National Healthcare Anti-Fraud Association (NHCAA) conservatively estimates that healthcare FWA costs the nation about $68 billion annually, representing 3% of the nation's $2.26 trillion in healthcare spending.2 FWA estimates from commercial health plans range as high as $230 billion annually, or
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Netsmart Acquires SNF Claims Data Analytics Solution CORE Analytics
What You Should Know:
- Netsmart announced that it has acquired CORE Analytics, the industry-leading skilled nursing facility (SNF) claims data analytics offering from Zimmet Healthcare.
- With the addition of Core Analytics, Netsmart Simple™is now the only solution suite in the market capable of calculating quality measures and Five-Star ratings leveraging Minimum Data Set (MDS), Payroll-Based Journaling (PBJ) and UB-04 claims data.
Software Solutions to Problems in
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Zelis Acquires Healthcare Cost Control Provider Payer Compass
What You Should Know:
- Healthcare payments company Zelis today announced an agreement to acquire Payer Compass, a healthcare provider of reimbursement and claims pricing, administration, and processing solutions. Financial terms of the transaction were not disclosed.
- Through the acquisition, Zelis will integrate Payer Compass into its existing solution suite to further help clients and their members manage rising healthcare costs and establish more transparent and affordable
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