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Prior Authorization

DrFirst Acquires Myndshft to Expedite Access to Specialty Medications and Reduce Burden on Providers

by Fred Pennic 04/18/2024 Leave a Comment

DrFirst Acquires Myndshft to Expedite Access to Specialty Medications and Reduce Burden on Providers

What You Should Know:  - DrFirst has announced a strategic acquisition of Myndshft Technologies, Inc., an end-to-end real-time medical benefits and automated prior authorization (PA) software-as-a-service (SaaS). - Myndshft software-as-a-service automates and simplifies time-consuming healthcare patient access tasks associated with prior authorization, eligibility and benefits verification, and patient financial responsibility, freeing providers and payers to concentrate more fully on
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AKASA Unveils Gen AI Assistant, Cuts Prior Authorization Time by 50%

by Fred Pennic 03/14/2024 Leave a Comment

AKASA Unveils Gen AI Assistant, Cuts Prior Authorization Time by 50%

What You Should Know: - AKASA, a leader in generative AI (GenAI) solutions for the revenue cycle, today announced the launch of Authorization Advisor™. - Authorization Advisor tackles the time-consuming and error-prone process of prior authorization, a major pain point for healthcare providers. Prior Authorization Made Easy with AI Prior authorization, a process requiring approval from insurers before delivering certain services, is a significant burden for healthcare providers. It
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Prior Authorization and Interoperability – Changing the Dynamics of Medicare

by Don Rucker, MD – Chief Strategy Officer, 1upHealth 02/22/2024 Leave a Comment

Prior Authorization and Interoperability – Changing the Dynamics of Medicare

CMS and Medicare are trying to change the dynamics of American healthcare. No need to rehash the well-known issues but what is new is the change in the hotspot. For the last 20 years, Medicare Fee for Service has been the hotspot of spending and value. You’ve heard the mantra (which dates at least as far back as 1906 with George Bernard Shaw’s play, “The Doctor’s Dilemma”). If you pay a set rate the medical establishment has an incentive to increase volume. Now fast forward to today and Medicare
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Cohere Health Secures $50M for AI-Powered Prior Authorization Platform

by Fred Pennic 02/02/2024 Leave a Comment

Cohere Health Secures $50M for AI-Powered Prior Authorization Platform


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CMS Finalizes New Interoperability and Prior Authorization Rule

by Fred Pennic 01/18/2024 Leave a Comment

CMS Finalizes New Interoperability and Prior Authorization Rule

What You Should Know: The Biden-Harris Administration has finalized a new rule that streamlines the prior authorization process and improves health data exchange across the healthcare system. The CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) represents a significant step towards reducing bureaucratic burdens, accelerating access to care, and fostering a more patient-centered healthcare experience. Streamlining Prior Authorization The rule tackles the often
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RCM: Why Generative AI is Needed for Prior Authorization Reform

by Michael Rivers, MD, Sr. Medical Director of Ophthalmology, ModMed 06/23/2023 Leave a Comment

RCM: Why Generative AI is Needed for Prior Authorization Reform

The headline-grabbing emergence of generative AI platforms, such as ChatGPT, BARD and BingGPT, has forced leaders across all verticals to ask, “What can we optimize with AI?” The AI chatbots remain in early stages of their development, but they have shown enough promise to suggest their full arrival is imminent. Every industry is currently weighing the best way to deploy AI, and that includes healthcare, where efficiency and improved workflows can make a tangible impact on the care that patients
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6 Ways Health Payors Can Leverage Intelligent Document Processing for Cost Savings

by Tom McCann, Growth Strategy & Business Development, Instabase 04/25/2023 Leave a Comment

6 Ways Health Payors Can Leverage Intelligent Document Processing for Cost Savings

The prevailing global economic conditions are negatively impacting the healthcare industry. Continuing staff shortages, endemic COVID-19, high inflation rates, and supply chain disruptions continue to drive medical costs higher, worsening what is already a persistent challenge for health insurers.  To offset rising healthcare costs, health insurance payors are challenged to find ways to contain their own costs by streamlining their processes and tightening their belts, which invariably
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Report: Prior Authorization for Biomarker Testing Leads to Treatment Delays For Cancer Patients

by Syed Hamza Sohail 04/14/2023 Leave a Comment

Report: Prior Authorization for Biomarker Testing Leads to Treatment Delays For Cancer Patients

What You Should Know: Biomarker testing is a necessary tool in the advancing world of precision cancer treatment. According to a new survey released by CancerCare, a leading national cancer support organization, biomarker testing helped doctors tailor therapy for nearly all the respondent patients (93%) whose cancers were tested over the past three years. Two in 10 cancer patients (20%) surveyed were able to avoid unnecessary chemotherapy and/or radiation and 10% became eligible for
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Salesforce Launches New Customer 360 for Health Capabilities to Deliver More Personalized Patient Experiences

by Jasmine Pennic 04/13/2023 Leave a Comment

What You Should Know: - Salesforce today announced new Customer 360 for Health capabilities that help healthcare providers deliver more personalized patient experiences and reduce operational costs. - Customer 360 for Health helps healthcare and life sciences organizations enhance the overall care experience with the full power of Salesforce technology, including real-time data from Data Cloud, Einstein AI, and automation with Flow.   New Customer for
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How Search Makes Clinical Natural Language Processing Useful in the Real World

by Kevin Agatstein, CEO, of KAID Health & Dimitri Linde, Clinical AI Specialist at KAID Health 03/24/2023 Leave a Comment

How Search Makes Clinical Natural Language Processing Useful in the Real World

Clinical Natural Language Understanding (cNLU), the technology by which computers extract meaning from clinical text, is quickly becoming a common feature in the healthcare IT landscape. In 2021, 30% of surveyed healthcare organizations were either using or exploring the technology.  (Gradient Flow, 2021). Similar adoption is occurring in the UK as well. (Wu et. al, Nature, 2022). Today, cNLU is being applied to billing/coding, trial enrollment, registry creation, clinical decision support,
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