Legal and compliance are often seen as roadblocks, but they don't have to be. Learn how including legal at the start can reduce delays and help healthcare payers adopt AI faster, with less risk.
COB recovery performance depends on when primary coverage is identified. Learn how pre-pay, pre-claim, and post-pay approaches impact cash flow, workload, and net value.
Automation is important, and it is growing increasingly useful in healthcare operations. However, automation does not replace healthcare experts. Discover how automation removes low-value work so experts can focus on what actually matters.
Responsible AI in healthcare depends on governance, not just models. Learn how healthcare leaders can scale AI with transparency, control, and trust.
Healthcare leaders struggle to adopt new technology when disruption is treated as inevitable. Learn how to modernize operations without sacrificing performance.
Medical-benefit drug spend carries hidden risk. Learn why discretion, not fraud, drives overpayments and how analytics restore control.
Up to 60% of subrogation analyst communication effort is wasted, leading to missed recoveries and inflated administrative costs. Streamlining operations could cut workforce needs by up to 30% and transform payer return on investment.
Improper payments cost billions. Discover how smarter tools uncover hidden waste and protect healthcare dollars.
With President Trump expected to announce a Medicare pilot program that enables Medicare CBD reimbursement for certain cannabidiol (CBD) treatments, we raise and track the questions that impact payers the most.
DRG errors are costing payers millions, but the shift to AI-supported validation is rewriting what accuracy and scale can look like. Discover how modern DRG review programs can protect financial integrity while smoothing provider relationships.
With soaring utilization costs and claims volume, healthcare payers face an unsustainable challenge. Through candid conversations with payers and industry experts, the Machinify OS/AI Summit unlocked insights to make healthcare payments more transparent, efficient, accurate, and compliant.
After nearly missing a major surgery due to an insurance issue, Gordon Chen invested his data science career in healthcare to fix inefficiencies for other patients.