Is Optum Real for real?

Providers increasingly accuse payers of delaying and denying reimbursement for claims. Now, UnitedHealth Group's Optum subsidiary is hoping to change the dynamic through what they claim is a real-time claims management program leveraging tech.

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Top Story Is Optum Real for Real? Providers increasingly accuse payers of delaying and denying reimbursement for claims. Now, UnitedHealth Group's Optum subsidiary is hoping to change the dynamic through what they claim is a real-time claims management program leveraging tech. Sponsored How Can AI Transform Revenue Cycle Management Technology? Presented by Smarter Technologies A new report reveals how medical billing staff perceive revenue cycle management software and the role that AI could play to improve revenue cycle management (RCM) tech.  Get the full report here.

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7 HLTH Announcements You Don't Want to Miss As always, this year's HLTH conference brought a slew of announcements — from product launches to funding rounds to new partnerships. This list features short summaries for seven of the conference's most notable announcements. Centene CEO: ICHRA Is the Future of Individual Health Insurance During a Monday session at the HLTH Conference in Las Vegas, Centene CEO Sarah London shared her thoughts on ICHRA, calling it the "future of individual health insurance."  Ventyx Bio Cardiovascular Drug's Phase 2 Results Set Up Talks With a Big Pharma Firm In a placebo-controlled mid-stage study, Ventyx Biosciences' oral NLRP3 inhibitor led to rapid and sustained reductions in levels of a protein that's an indicator of cardiovascular disease risk. The brain-penetrating properties of this once-daily pill also have potential applications addressing inflammation that drives neurodegenerative disorders. Technology Evolution: Why Clinicians Must Expand Their Sources of Data Healthcare today requires more than the partial snapshot offered by legacy technology. By integrating diverse data sources such as wearables, claims, communications, and ADT feeds, clinicians gain a comprehensive, real-time view of their patients' health.  Closing the Rural Divide with Device-enabled Virtual Care Bringing care to people where they are improves community health outcomes — we must operate with more urgency to shore up care resources in rural areas.

Video   Virtual OUD Treatment Is Proving Valuable A report from the Peterson Health Technology Institute found that virtual opioid use disorder companies are just as effective as standard in-person treatment — and they can improve retention. For a long time, the OUD treatment community believed that care needed to be delivered in person, noted Caroline Pearson, an executive director at Peterson Health Technology Institute. However, particularly since the pandemic, virtual care has proven to be effective and convenient, especially in place where there aren't many providers.

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MedCity Pivot Podcast: Price Transparency is the New North in the PBM World In this episode, a pharmacy benefit management executive and a pharmacy startup talk about why benefit verification, prior authorizations, and patient affordability still break the workflow and how smart integrations, real-time eligibility, and intuitive design can reduce friction for all involved. View Now

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