In his first year, Secretary of Veterans Affairs Doug Collins is celebrating wins, while targeting issues such as ...

Lawmakers are in a standoff over whether to extend ObamaCare subsidies, with Republicans proposing reforms to reduce health ...

Behind every healthcare claim, authorization, and member interaction lies a dense web of rules and workflows that payers must ...

Open enrollment isn’t a feature of a functioning market. It’s a symptom of a system that values administrative ritual and ...

A new report from the country's two leading insurance industry organizations alleges providers are "flooding" the No Surprises Act dispute process to score higher payments. | A new report from the two ...

Optum has introduced Optum Real, a real-time AI claims system that offers faster reimbursement by connecting payers and providers in real time. Optum Real provides instant coverage validation through ...

The woman's lawyer wrote to the Ministry of Health asking for urgency, flagging that her client had terminal cancer and just ...

The Democrats’ government shutdown is limiting services for veterans and making life miserable for VA employees, and things ...

A metro Detroit physician assistant and pharmacy tech respond to an op-ed penned by Blue Cross Blue Shield of Michigan's CEO ...

UnitedHealth Group (NYSE:UNH) is piloting a new AI-powered medical claims processing system, according to a Bloomberg report. The system, called Optum Real, translates complex health plan rules into ...

CMS has instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service Oct. 1, 2025, and later for certain services impacted by select expir ...