dismiss

Clean Sweep Live Auction on Wed. May 1st. Click to view the full inventory

DOTmed Home MRI Oncology Ultrasound Molecular Imaging X-Ray Cardiology Health IT Business Affairs
News Home Parts & Service Operating Room CT Women's Health Proton Therapy Endoscopy HTMs Pediatrics
SEARCH
Posição atual:
>
> This Story

starstarstarstarstar (1)
Início de uma sessão ou Registo to rate this News Story
Forward Printable StoryPrint Comment
advertisement

 

advertisement

 

Artificial Intelligence Homepage

Aidoc announces $27 million in VC funding to advance AI in imaging Brings company's total funding to $40 million

Fredrik Palm ContextVision appoints new CEO

New study questions patient understanding on AI in radiology Asserts that greater education and communication is required

ACR engages in collaborations for AI development with launch of AI-LAB platform Allows radiologists to create algorithms of their own

New AI software identifies make and model of cardiac implants in seconds Speed up diagnosis and delivery of treatment for patients with faulty devices

Dicom Systems scores enterprise imaging contract with Radiology Partners Will integrate IT and clinical workflows of more than 850 provider facilities

Apple study suggests wearable technology may be useful in detecting atrial fibrillation May assist in stroke and hospitalization prevention

Nvidia unveils Clara AI platform at GPU Technology Conference Equipped with 13 state-of-the-art classification and segmentation algorithms

BSWH to install Glassbeam's CLEAN blueprint to leverage machine uptime Will include integrated CMMS software by EQ2

Beyond the hype: How practical AI is enhancing radiology Insights from Imad B. Nijim, chief information officer for MEDNAX Radiology Solutions

How artificial intelligence can transform payment integrity

By Krithika Srivats

In 2013, the actress Angelina Jolie published an opinion column in the New York Times that described her decision to undergo a preventive mastectomy after testing positive for the BRCA gene, a mutation that can lead to breast cancer.

Within two weeks of the column’s publication, more than 4,500 BRCA tests were ordered across the nation, a 64 percent rise from the same time period the previous year. Interestingly, researchers found no increase in the number of breast cancer diagnoses, and mastectomy rates actually declined. This suggested that many of the tests were given to populations at low-risk of carrying the mutation. In the end, a few hundred words written by a celebrity cost the healthcare system nearly $14 million for tests that were largely unnecessary.
Story Continues Below Advertisement

New & Refurbished C-Arm Systems. Call 702.384.0085 Today!

KenQuest provides all major brands of surgical c-arms (new and refurbished) and carries a large inventory for purchase or rent. With over 20 years in the medical equipment business we can help you fulfill your equipment needs


Though this was a clear example of overutilization, the payment integrity programs of most health plans mounted responses that were either ineffective or non-existent. A closer look at most payment integrity programs reveal why they were ill-suited to the task.

While specific components of a payment integrity program can vary among health plans, most include a combination of human-based review and rules-based automation software to identify anomalies among thousands of claims. However, manually-driven payment integrity programs – even those augmented with automation and analytics software – identify less than half of all claims anomalies, which may or may not prove to be improper claims after further investigation. In addition, this resource-intensive and costly process was largely built on a pay-and-chase model, whereby outliers are targeted and recovery of previous paid claims are initiated.

A 2018 Gartner report, “U.S. Healthcare Payer CIOs Must Adopt Prospective Payment Integrity to Thwart Improper Claims Payment and Fraud,” concluded that health plan executives can significantly improve the financial returns from payment integrity programs” through prospective processes and “exponentially increase financial performance and improve provider relationships.”

Fortunately, technological advances have given health plans an opportunity to build a better payment integrity system – one that doesn’t just anticipate emerging trends from, say, a high-profile endorsement of an expensive medical test, but most other forms of overutilization.

The solution? Artificial intelligence (AI).

AI has been successfully applied in many areas of healthcare with proven results – from the creation of better care pathways to advances in disease research and reducing medical errors. AI also has the potential to be a significantly more reliable, efficient, and cost-effective solution to mitigate improper claims payments that cost the healthcare industry hundreds of billions of dollars every year.
  Pages: 1 - 2 - 3 - 4 >>

Artificial Intelligence Homepage


You Must Be Logged In To Post A Comment

Anuncie
Aumente a Sua Perceção da Marca
Leilões + Vendas Privadas
Comece
O mais melhor preço
Comprar Equipamento/Peças
Encontre
O preço o mais baixo
Notícia diária
Leia
A notícia a mais atrasada
Diretório
Browse tudo
DOTmed Usuários
Ética no DOTmed
Veja o nosso
Programa das éticas
O ouro parte o programa do vendedor
Receba PH
Pedidos
Programa do negociante do serviço do ouro
Receba RFP/PS
Pedidos
Fornecedores de Healthcare
Veja tudo
Ferramentas de HCP
Trabalhos/Treinamento
Achado/suficiência
Um trabalho
Parts Hunter +EasyPay
Comece as peças
Citações
Certificado recentemente
Vista recentemente
Usuários certificados
Recentemente Rated
Vista recentemente
Usuários certificados
Central Rental
Equipamento do aluguel
Para menos
Vender Equipamentos/Peças
Comece
A maioria de dinheiro
Preste serviços de manutenção ao Forum dos técnicos
Ajuda do achado
E conselho
Simples RFP
Comece o equipamento
Citações
Mostra de comércio virtual
Serviço do achado
Para o equipamento
O acesso e o uso deste local são sujeitos aos termos e às condições do nosso OBSERVAÇÃO LEGAL & OBSERVAÇÃO DA PRIVACIDADE
Propriedade de e proprietário DOTmeda .com, Inc. Copyright ©2001-2019 DOTmed.com, Inc.
TODOS OS DIREITOS RESERVADOS