In this podcast, Tim explores how deeply embedded incentives, inefficiencies, and subjectivity in the current claims adjudication process create opportunities for manipulation and inefficiency.
Traditionally, payers have cast wide nets and asked providers to navigate hurdles only to claw back money after a payment has been made.
Most payers struggle to incorporate legislative, coding, and clinical changes into policy as well as to validate that policies are consistently applied to make timely, accurate payments of claims.
The last decade has seen AI’s escalating impact on a variety of industries take shape, and perhaps no vertical has been impacted as much as healthcare.
Strategies for Successful Adoption of Pre-Payment Solutions
Translating clinical guidelines into AI-compatible formats requires understanding the guideline's intent and how AI applies rules at scale.
Artificial Intelligence (AI) is often hailed as the savior of healthcare, but can it really handle modern medicine? Here are three big reasons AI might stumble before it soars.
We're building a healthcare intelligence company that delivers unmatched value, transparency, and efficiency to payers across the country.
New executive orders prioritize rapid artificial intelligence (AI) innovation and reduced regulatory insight. How do these changes impact payers?
We need an operating system for AI: a framework that ensures transparency, control, and real impact. What would that look like? Let’s break it down, layer by layer.
Healthcare is now facing its own innovator’s dilemma. Can the healthcare industry adapt or will it continue to cling to fax machines?
Explore how the new Physicians Make Decisions Act (PMDA) is reshaping conversations around liability, ethical boundaries, and the integration of AI into clinical practice.