Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...
The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...
California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the ...
A recent opinion from the Commonwealth Court of Pennsylvania has changed the rules for Utilization Review and thrown open the doors to a new class of litigants. In Keystone Rx, LLC v. AmeriHealth (Fee ...
Utilization management involves methods by health care plan administrators to minimize costs while also maintaining the quality of care. The process is intended to prevent wasteful spending but not to ...
SAN DIEGO--(BUSINESS WIRE)--Mitchell International, Inc., a leading provider of technology, connectivity, and information solutions to the Property & Casualty (P&C) claims and Collision Repair ...
PALM BEACH GARDENS, Fla.--(BUSINESS WIRE)--Dane Street is proud to announce its URAC accreditation for Independent Review Organization (IRO) and Workers’ Compensation Utilization Management (WCUM) ...
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