More than 80% of physicians now use AI in their clinical practice, double the share of just three years ago, with documentation and coding among the most common applications. That shift has quietly created a new category of billing inaccuracy.…
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A patient leaves a clinic with a prescription, drives to the pharmacy and discovers the copay is higher than expected, a prior authorization is required or the medication is out of stock. They leave empty-handed. Therapy is delayed. Adherence is…
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Tamika Lasege, MD, will serve as chief medical officer for CareSource Georgia. Dr. Lasege is a neonatologist and pediatrician, according to a June 24 LinkedIn post from the company. As chief medical officer, Dr. Lasege will lead the managed care…
This webinar is on-demand and can be viewed at your convenience. Labor and delivery units demand more from clinicians than almost any other care setting. Data is constant, decisions are immediate, and the stakes couldn’t be higher. Yet documentation burden,…
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Sarosh Shetty will serve as senior vice president and CIO of Optum Insight’s provider business. Mr. Shetty shared the update on LinkedIn in June. Optum Insight is Optum’s consulting and data analytics division. In this role, he will focus on…
Elevance Health will exit the small group ACA market in Ohio in 2027, the company confirmed with Becker’s. “Small businesses are increasingly seeking health coverage options that deliver affordability, flexibility, and more predictable costs,” an Anthem spokesperson said. “To meet…
Blue Cross Blue Shield of Michigan and Blue Care Network are updating their professional “incident-to” services and billing reimbursement policy for eligible providers serving commercial members, according to a June provider newsletter. The incident-to billing practice permits services performed by…
Blue Shield of California and Fresno-based Community Medical Centers have reached a new contract agreement, ending a more than four month network break. The agreement restores in-network access for the insurer’s HMO, PPO, Medicare Advantage and ASO members across Community’s…
CommunityCare and direct primary care technology company Mending are partnering to embed DPC providers into Oklahoma ACA plans beginning in 2027. Mending, which is winding down its own ACA plans in Maine and Oklahoma, will shift to powering DPC access…
The Justice Department has charged 455 defendants, including 90 physicians, nurses and other licensed medical professionals, for allegedly participating in healthcare fraud and opioid abuse schemes. The charges are part of the department’s 2026 National Healthcare Fraud Takedown, which is…
