Clover Health experienced a data breach, according to a July 17 filing with the Securities and Exchange Commission. The insurer detected abnormal login activity on some information systems on July 4. Clover said it launched incident response procedures “immediately” and…
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The country’s largest healthcare company is placing a bet on Anthropic. Optum, part of UnitedHealth Group, is partnering with Anthropic “to responsibly bring AI to healthcare to help people live healthier lives, reduce the administrative burden, and make the health…
Blue Cross and Blue Shield of Minnesota expanded Blue Care Advisor, the company’s AI-powered “digital front door,” to members across its Medicare plans. According to a July 7 news release, Blue Care Advisor launched in 2024 for members with employer-based…
Cigna’s Evernorth Health Services announced Pharmacy Forward, an AI-powered program for specialty care, July 1. The program, backed by a $100 million investment through 2028, will first launch with Evernorth’s Accredo Specialty Pharmacy. Pharmacy Forward will integrate clinical data, AI-generated…
CVS Health’s insurance branch will roll out “Aetna Mental Health On Demand” in 2027, the company said in a May 28 news release. Aetna members who are at least 13 years old will be able to access licensed clinicians via…
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CVS Health’s Aetna launched the next generation of its claims assist manager, an agentic AI claims adviser. Using claims adjuster AI agents, the tool reduces processing time by more than 20% for complex claims that need manual review, according to…
It’s no secret that one of AI’s greatest use cases has been to streamline internal operations and administrative tasks at healthcare organizations. But, for some payers and their parent companies, these technologies are going even further, now serving as a…
Medicare Advantage insurer Clover Health is aiming for Counterpart Health — a subsidiary bringing the carrier’s AI-powered clinical decision support tool to external payers and providers — to serve “as a long-term growth engine,” a Clover executive said on a…
Blue Shield of California debuted its virtual-first Virtual Blue healthcare plan just over three years ago. Now, the data is rolling in. The program began in 2023 through a collaboration with tech-enabled healthcare platforms Accolade — now owned by Transcarent…
When it comes to attempts at insurance fraud, the story behind claims could be a major threat. In a 2025 issue brief shared with Becker’s, the National Health Care Anti-Fraud Association outlined several possibilities for fraud that AI could spur:…