Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them. Objective: This study was designed to assess physician ...

A score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies. Objectives: To (1) ...

RICHARDSON, Texas, December 08, 2025--(BUSINESS WIRE)--MedeAnalytics, an industry pioneer in AI-powered enterprise healthcare intelligence, analytics, and data management, and Basys.ai, an innovation ...

NEW YORK--(BUSINESS WIRE)--Today, VirtualHealth announced the release of a completely redesigned Utilization Management (UM) module within its cloud-based care management solution HELIOS®. The newly ...

GenHealth.ai and Guidehealth achieved up to a 60% reduction in Utilization Management workload using GenHealth’s AI-native platform, leading to $1.2M in annual savings. The system automates clinical ...