Claims Processing

Underpayment is one of the most damaging issues financially for hospitals reporting that over a year, 32% of claims were underpaid, representing $5B in lost revenue, says John Yount, Chief Innovation Officer, FinThrive.

Baptist Health Chief Revenue Officer says the health system will often eat the cost of a service rather than delay care.

Patient self-pay is increasing, says Curae Finance, which announced the new partnerships.

Managing the cost of GLP-1 drugs for weight loss is the top priority in pharmacy benefits, says Mercer survey.

Abridge technology will be deployed across Allegheny Health Network’s 14 hospitals and the Highmark insurance division.

Reasons include the expected end of tax credits, increasing costs and utilization and, potentially, tariffs.

An Advanced Explanation of Benefits for upfront estimates remains an outstanding provision of the No Surprises Act, senators say.

Rule will cause at least 1.8M Americans to lose ACA coverage and result in higher premiums and out-of-pocket costs, lawsuit says.

The health system and Optum Ventures are among more than 10 investors in physician-led AI company Humata Health.

This is the third such collaboration of rural hospitals operated by the for-profit Cibolo Health.