MobiHealthNews reached out to executives from across the digital health landscape and questioned them about unexpected and impactful occurrences from the past year. Leaders singled out the closing of retail clinics, challenges in the Medicare…
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What You Should Know:
– Soda Health, a health tech company transforming the way healthcare benefits are utilized, has announced a $50 million Series B funding round led by General Catalyst, with participation from former…
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David J. Sand, MD, MBA Chief Medical Officer at ZeOmega
The U.S. healthcare system has been undergoing its own stress test. Stakeholders are currently experiencing a variety of pressures with a primary focus on finances, including administrative…
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Steve Kim, CEO of Valer
As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior…
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What You Should Know:
– Healthpilot, an AI-powered Medicare comparison platform, and Publix Supermarkets have joined forces to simplify the process of choosing Medicare plans for seniors.
– Publix Pharmacy customers can now access Healthpilot’s comparison…
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The following is a guest article by David Lareau, CEO at Medicomp Systems
A couple of years ago, we predicted an impending “explosion” of Medicare Advantage (MA) fraud and penalties. That prediction has now become…
What You Should Know:
– Essence Healthcare, a provider of Medicare Advantage (MA) plans forms a new partnership with ŌURA, the maker of the Oura Ring.
– Starting in 2025, eligible Essence MA members will receive…
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Top News
A US Senate subcommittee report finds that UnitedHealthcare, Humana, and CVS disproportionately denied prior authorization PA requests for post-acute care in their Medicare Advantage patients, often by using AI-driven tools.
UnitedHealth’s denial rate…
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DarioHealth, a digital chronic-condition-management platform, announced it entered into a new contract with a national Medicare Advantage health plan and plans to launch its behavioral health initiative, Twill by Dario, for the plan’s members in…
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Katie Sender, MSN, RN, PHN, CRC VP, Clinical and Coding Services at Cotiviti, Inc.
Risk adjustment requires constant attention to ensure accurate coding, timely regulatory compliance, and streamlined communications across the payer-provider continuum. Increasingly rigorous…
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