Claims Management

FL Health System Leverages AI to Streamline Utilization Management

March 22, 2023 - Florida-based Halifax Health deployed an artificial intelligence-based solution to streamline utilization management workflows across its three hospitals this week. The health system will leverage a combination of XSOLIS' CORTEX platform and Physician Advisory Services to address administrative challenges and inefficiencies between its...


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Partnership Aims to Improve Health System Utilization Management with AI

by Shania Kennedy

AnMed, a nonprofit health system serving residents of upstate South Carolina and Georgia, will leverage XSOLIS’ artificial intelligence (AI) and machine learning (ML) tools to drive greater...

Using AI to Streamline the Provider-Payer Relationship

by Shania Kennedy

Providers and payers play key roles in healthcare delivery. More often than not, the two must collaborate to ensure that patients and beneficiaries move through their care journeys as efficiently as possible while complying with state and...

Change Healthcare Pushes Scale, Finds Value in Blockchain

by Jennifer Bresnick

Blockchain has quickly risen to become one of the most talked-about technologies in the healthcare sector and elsewhere, dangling a tantalizing “chain of trust” in front of an industry...

Borrowed from Retail, Anthem’s Big Data Analytics Boost Member Engagement

by Jennifer Bresnick

Commercial insurance companies are facing innumerable challenges as internal and external changes continue to buffet the healthcare industry.  As both leaders in the field of value-based care and...

Unique Device Identifiers in Claims Could Aid Healthcare Analytics

by Jennifer Bresnick

Adding unique device identifiers (UDIs) to claims data could significant improve patient safety and healthcare analytics, argues a new letter to CMS and the FDA, and speeding up the regulatory process...

Using Business Intelligence, KPIs for Revenue Cycle Management

by Joncé Smith

The healthcare industry’s transition to value-based care does not end with clinical patient care. The shift also extends into healthcare providers’ revenue cycle management processes. For...

Using Data Analytics Tools for Healthcare Claims Management

by Joncé Smith

Effective claims management requires healthcare organizations to deploy a multi-faceted strategy that relies on data analytics and includes many phases of the revenue cycle, beginning when the patient...