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Industry Insights & Strategy

CommunityLIVE Takeaways Every Payer Will Want to Hear About

Authored by: Kevin Flanagan As a healthcare payer, you’ve never been short on data; there’s plenty of it. But making that data usable and ready for artificial intelligence tools is an entirely different challenge. At this year’s CommunityLIVE, where we explored new technologies and shared real stories about how payers are using them, one message

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Technology & Innovation

Wondering What AI Means for You? Start Here.

Authored by: Kevin Kowalkowski  AI is everywhere, from headlines to smartphones to agency planning sessions. And for many public sector organizations, the question remains: What exactly does AI mean for our organization, and how should we begin using it? While the buzz keeps growing, teams can feel overwhelmed by all the possibilities and unsure exactly

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Security & Compliance

Appeals and Grievances: Data Driven Compliance…How Do We Get There?

Appeals and grievances departments work diligently to maintain compliance, keep up with regulations and serve members. However, with large caseloads and many moving parts, manual processes often open up potential risks. As a result, many are turning to data-driven compliance and process automation to mitigate that risk.

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Technology & Innovation

How Payers Improve Agility and Compliance Through Intelligent Automation

Successfully navigating these and future challenges requires agility, according to a report published by McKinsey and Company. Research show that 81% of payers say they’re investigating in technology to improve the member experience. And keeping your employees happy is vital when 44% of employees admit they’re looking for a new job.

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Solutions & Use Cases

Getting Your Budget for New A&G Solutions Approved

Authored by: Pat Goetz As a business director, you’re skilled at communicating with unhappy members, efficiently managing the appeals and grievances process and ensuring that the work gets done correctly. But when you do your job well, your manager might question the need to invest in new technology. After all, you’re already doing a great

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