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Claims Processing

By Susan Morse | 09:54 am | April 29, 2025
The health system and Optum Ventures are among more than 10 investors in physician-led AI company Humata Health.
By Susan Morse | 11:19 am | April 21, 2025
This is the third such collaboration of rural hospitals operated by the for-profit Cibolo Health.
By Susan Morse | 10:10 am | April 15, 2025
AMA wants Optum to stop its approach for recouping loans and to suspend all claim filing deadlines.
By Susan Morse | 10:36 am | April 11, 2025
Starting Jan. 1, 2026, payers must send prior authorization decisions within 7 days and expedited decisions within 72 hours.
By Susan Morse | 11:23 am | February 26, 2025
Letter to CEO Andrew Witty follows report of DOJ launching investigation into the company's billing methods.
By Jeff Lagasse | 10:02 am | February 14, 2025
The plaintiffs have accused the insurer of using artificial intelligence algorithms to illegally deny claims.
By Jeff Lagasse | 10:48 am | February 04, 2025
Initiatives include adding new concierge teams to support customers experiencing challenges with claims payments.
By Jeff Lagasse | 11:01 am | February 03, 2025
Reasons include prior authorization or referral, excluded services and administrative issues, KFF finds.
By Jeff Lagasse | 02:54 pm | January 28, 2025
The figure of 190 million people has been amended from past estimates, which put the total at about 100 million.
By Susan Morse | 11:04 am | January 06, 2025
Mayo alleges that Sanford in South Dakota is responsible for $739,956.20 in medical expenses incurred by a patient in 2022.