Becker's Payer Issues | Payer News

Inpatient CDI has traditionally depended on disruptive retrospective queries, fragmented workflows, and clinicians revisiting the record days or weeks after discharge. What changes when context and documentation guidance arrive during the encounter, while the clinical context is still fresh? Health…

Clinical reviewers open a utilization management or appeals case and spend most of it assembling evidence — hundreds of pages, several source systems and a fax queue that has outlasted every modernization plan built around it. The determination itself is…

In 1987, economist Robert Solow observed that the computer age was visible everywhere except in the productivity statistics. The machines were bought; the work stayed put. The payoff came a decade later, once companies rebuilt around the technology. Revenue cycle…

AI can transform utilization management — but only when it is built into the decisions and workflows that determine how cases are reviewed, prioritized and supported throughout the patient stay. Building on the session “”Beyond the Worklist: Architecting AI-Enabled Utilization…

A patient who isn’t ready on the morning of surgery becomes a cancellation, a no-show or a case that starts late. By then, there are no easy choices left. The cost shows up in places a cancellation report doesn’t track.…