Author: Vedant Bhosale

The Future Must Be Less Wasteful, More Collaborative Misaligned policies, medical necessity screening tools, and incomplete clinical data are chief contributors to rising claims denial rates. They’re a challenge that costs hospitals and health systems nearly $20 billion per year,…

Healthcare payer marketers are caught between a rock and a hard place: They are responsible for driving growth for their organizations, yet are hamstrung by their legal and compliance colleagues in terms of the digital strategies they can deploy to…

The tools you rely on for effective digital advertising could disappear tomorrow. That’s not hyperbole, or a scare tactic. It’s already happening to healthcare providers right now. As trust in payers erodes and scrutiny around privacy intensifies, it’s only a…

In an interactive session at Becker's Fall Payer Issues Roundtable, Sri Palanisamy, Principal at ZS, led a discussion on unique opportunities and challenges of provider partnerships, particularly for Blue Cross Blue Shield (BCBS) plans. The panel included Jason Hover, vice…

For payers, drug formulary development and maintenance are essential for accurate reporting and tracking of prescription medications. An up-to-date and well-established classification resource can help payers and other stakeholders manage their drug formulary more efficiently. While several classification resources are…

Payer business operations are often cumbersome due to siloed departmental management. This fragmentation creates friction for navigating customer service and addressing complex inquiries across the enterprise.

Managing provider data is a significant challenge for many payers, due to frequent changes and inaccuracies in directory listings. Recently, generative AI and automation technologies have been identified as promising solutions. Research has shown these tools can meaningfully reduce payers'…

It’s time to shift from GenAI experimentation to meaningful implementation in healthcare with a strong focus on data integrity. The last decade has seen its fair share of volatility in the healthcare industry. From the rise of value-based payment models…

Fast-paced advancements in generative AI will change the core operations of every healthcare organization. AI-driven technology is not just a side project anymore. AI solutions including generative AI are finally advanced enough to deploy at scale and provide a frictionless…

Navigating challenges and building trust in AI-driven Healthcare solutions Healthcare adheres to an elevated standard. This is evident in the rigorous training required for providers, the stringent safety protocols for life sciences professionals, and the stringent data and privacy requirements…