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.
Private-equity acquisitions of primary-care provider practices neither alter hospitalization rates nor affect acute-care outcomes, according to new research out of Brown University.
Epic makes the list with its enterprise inpatient EHR and related platforms. So does PCC, aka Physician’s Computer Company, which supplies pediatric-specific ambulatory EHR and practice-management products and services.
In a survey, employers told the Business Group on Health that they aren’t yet seeing evidence of long-term health benefits from taking GLP-1s for weight loss, leaving them unsure how to manage costs while continuing to cover them.
Parmjit “Paul” Parmar, 55, from New Jersey has also been ordered to pay $125 million in restitution. The scheme to defraud investors was uncovered in 2017.
The insurance arm of UnitedHealth Group said the shift is part of its ongoing effort to eliminate the barriers between care delivery and medical coverage. The full list of services exempt from prior authorizations includes diagnostic tests and many outpatient surgeries.