Breaking down silos: Why future cost containment demands a connected approach across UM, Claims, and PI
Health plans have chased cost containment at every stage [...]
Why health plans are bringing utilization management in-house
Why health plans are bringing utilization management in-house Many [...]
From AI hype to real outcomes: Lessons for prior authorization from the 2025 Gartner® Research
Health plans have pursued prior authorization (PA) automation for [...]
How health plans can use prior auth data to unlock value-based insights
Health plans are sitting on a valuable but underleveraged [...]
Cohere Review Assist: AI that works with your workflow—not against it
Healthcare technology teams know the drill: any solution that [...]
DTR workflows that work: Medical policy digitization
Let’s say you’ve cleared your compliance strategy's first big technical [...]
DTR workflows that work: The case against clinical questionnaires
Do you ask the auth submitter a series of clinical [...]
Prior auth that fits: Creating better routines for providers
The challenges of a one-size-fits-all approach Health plans often [...]
CMS-0057-F: APIs are only the tip of the iceberg
Implementing CMS-0057-F, which mandates using FHIR APIs for prior [...]
How AI is simplifying prior authorization
Imagine assembling a complex piece of furniture. You have [...]
