Medicare's new pilot program, WISeR (Wasteful and Inappropriate Service Reduction), is set to revolutionize the decision-making process for coverage of certain procedures by integrating artificial ...

A Raleigh-based company is helping people appeal their health insurance denials. Founders of Counterforce Health said the company was built on fighting what they call “the ...

Artificial intelligence will soon be used for prior authorization for certain Medicare services in Texas and five other ...

With denials on the rise, more health systems are turning to AI in the revenue cycle. Payer denial prevention emerged as a significant theme throughout almost every session at HFMA 2025. At a time ...

Stephanie Nixdorf was at Disney World with her family in December 2021 when she got the call. A mysterious bump on her elbow was melanoma, her doctor said. Tests later showed it was Stage 4, with ...

RALEIGH, N.C. (WTVD) -- At Research Triangle Park (RTP), companies are leading the way with artificial intelligence and trying to harness their powers for the greater good. Nearly 1 in 5 Americans ...

For Neal Shah, the breaking point came during his wife's cancer treatment. He remembers being overwhelmed, surrounded by stacks of hospital bills, denial notices and insurance statements. When he and ...

WILMINGTON, N.C. (WECT) - It can be one of the most frustrating parts of healthcare: when insurance denies coverage. However, a new AI tool aims to help patients battle back in a matter of minutes.

Insurers’ growing use of AI in coverage decisions has faced scrutiny from some lawmakers concerned that the technology could deny care unfairly, especially in the MA program. UnitedHealth and Humana ...

Forbes contributors publish independent expert analyses and insights. I’m an analyst covering neurotech's impact on business and society. Despite its growing “deeptech” bonafides, the US ...

AI advances in the last few years are changing this. LLMs have made it possible to parse through unstructured information in minutes. Combined with human expertise, it opens the door to working a much ...

What is your denials management process costing you? Between 2022 and 2023, the cost per management of a denial went up from $43.84 per denial (totaling $19.7 billion in 2022) to $57.23 per denial ...