Jill O'Brien, Morton Hospital's new CMO, says the essence of utilization management is providing the right care for the right patient in the right setting at the right time. The new CMO of Morton ...

Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

Building on its expertise in building artificial intelligence solutions for hospitals, Iodine Software rolled out new AI-based software to tackle the complex healthcare challenge of utilization ...

How MCG Indicia software (enhanced with AI capabilities) has improved medical necessity documentation and increased hospital staff efficiency The sources of EHR data that are beneficial in determining ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

Insurtech companies such as Oscar Health use technology to engage patients and offer risk-based, value-based care to engage providers in what is touted as a collaboration of savings, efficiency and ...