Payer-provider dynamics have been a persistent struggle in healthcare, particularly evident in heated contract negotiations. AI — such as clinicians using scribes associated with greater coding intensity and insurers harnessing AI platforms to authenticate claims and assist with prior authorization…
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When the CEO of behavioral health payer and managed care organization Magellan Health thinks about AI, its use falls into several buckets. But the verdict on whether AI can replace providers is unclear. Caroline Carney, MD, of Centene subsidiary Magellan…
Payers and providers are locked in an “AI arms race” over coding and claims, but some industry leaders are acknowledging the battle may be a distraction from providing patient care. “The bots battling the bots is a real thing,” Sachin…
Digital identity wallet service ID.me entered into a contract with CMS, with rollouts to improve secured access and user experience coming to Medicare.gov in early 2026. ID.me will act as an identity verification and sign-in option for the website. User…
Throughout 2025, health insurance leaders have weighed in on the role AI should play in the industry, from advancing operational efficiencies to integrating with consumer-facing technology. Here are 14 statements and updates on AI from health insurers in 2025: 1.…
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Elevance Health has rolled out its virtual assistant to 22 million commercial members, with a Medicare expansion planned for 2026. The tool, accessible through the Sydney Health app and affiliated plan websites, allows members to ask plain-language questions about coverage,…
Aetna is rolling out a generative AI-powered conversational assistant within its website and mobile app. The new tool synthesizes member benefits, provider networks and program information to deliver answers in plain language, eliminating the need for users to understand industry…
In June, Becker’s predicted that 2025 would shape up to be the year of AI agents in healthcare. While AI agents are nothing new, more insurers are getting on the bandwagon. AI agents complete tasks autonomously to achieve specific goals.…
Elevance Health said it is going all in on AI, but the tech’s potential risks in insurance have spurred recent regulations, signaling the public’s concern. Anita Allemand, PharmD, joined Elevance Health as chief growth officer earlier this year. She spoke…
Three health insurers have been named among the top 50 companies that are effectively adopting and scaling the use of artificial intelligence by Fortune. The AIQ 50 ranking measures Fortune 500 companies through a score that combines self-assessments, peer evaluations…