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.
A pharmacy benefit management company founded less than five years ago is teaming up with a drug pricing disrupter that will mark its second birthday next month.
Over the past three years, the value of claims waiting longer than 90 days for payment from commercial payers has risen by 33%. Stalled Medicare Advantage claims have spiked by even more.
In its annual outlook report released this week, Fitch Ratings says the coming calendar year will probably strike much of the sector as “another make or break” period.
