Providers utilize business intelligence to monitor referral patterns and collaborate with clinicians who order their services. Such analytics tools have also been deployed in the specialty to improve productivity, track patient satisfaction and bolster quality.
The state is accusing the insurer of colluding with the broader Blue Cross Blue Shield network to stifle competition and control prices. BCBSM denies the allegations.
The hack, which was revealed earlier this year in a report from Bleeping Computer, is said to have been limited to a legacy server. Oracle denied its cloud environment had been compromised.
Independence Blue Cross, the largest medical insurance provider in the Philadelphia area, does not admit to wrongdoing. It was accused in a lawsuit backed by the U.S. Department of Justice of misrepresenting the severity of patient illnesses to juice risk-adjusted Medicare payments.
With its $350M in new funding, EliseAI said it plans to build out its technology and sales force. It currently works with specialty provider groups to automate practice operations such as scheduling and insurance verification.
Scott Whitaker, the CEO of the industry lobby AdvaMed, told the Senate Finance Committee that he fears tariffs will only raise the cost of care and put patients at risk if companies are unable to overcome supply chain disruptions.
Citing sources familiar with the matter, the Wall Street Journal reports that UnitedHealth Group is being investigated for criminal fraud, likely stemming from its Medicare Advantage billing practices.
The unwanted spam calls were associated with Optum's home healthcare service. Plaintiffs alleged they received the marketing calls despite opting out and never signing up, in violation of federal consumer protection laws. The company does not admit to wrongdoing.
One Medical, a chain of primary care clinics owned by Amazon, is being sued by the family of a man who died due to alleged provider negligence. Now, court filings reveal staff improperly accessed the deceased man's protected medical records.
Andrew Witty is stepping down as CEO of UnitedHealth Group, citing "personal reasons." Former CEO Stephen J. Hemsley has taken over, the company announced Tuesday.
A whistleblower lawsuit claims CVS pharmacies have overbilled state Medicaid programs for prescription drugs—a practice allegedly ongoing since 2016. The company denies any wrongdoing.
