Forbes Healthcare

DECEMBER 11, 2024

Health insurers use AI to approve or deny claims. Now patients are getting access to AI-driven tools to fight back.

Insurance 305

Insurance 305

Sensible Medicine

NOVEMBER 23, 2023

I also want to say that I am confident insurers can behave poorly, peer to peer is an insult, and prior auth is a broken system, but medicine has to be careful not to offer unproven and costly things to desperate people, not to waste a scare resource (donated lungs) and this story is about inappropriate care offered by transplant surgeons.

Insurance 350

Insurance Medication 350

Forbes Healthcare

JANUARY 13, 2025

Price discrepancies for the same medical procedures show how unfair insurance practices erode trust, leaving patients confused, financially strained, and feeling helpless.

Insurance 301

Insurance Medication 301

Forbes Healthcare

SEPTEMBER 3, 2024

It's unclear whether big health insurers will expand their geographic footprints for 2025 as they have in the past.

Insurance 272

Insurance 272

Forbes Healthcare

OCTOBER 1, 2024

Health insurance companies including CVS Health's Aetna, Cigna and Humana are pulling back slightly on their Medicare Advantage footprints after years of expansions.

Insurance 280

Insurance 280

Forbes Healthcare

MARCH 23, 2024

Health insurers increasingly use prior authorization to review care decisions. This leads to delays and administrative burden. Policy fixes are addressing the problem.

Insurance 273

Insurance 273

Forbes Healthcare

DECEMBER 20, 2024

Health insurers are variably represented as knights, knaves, or pawns in public discourse. Getting their underlying motivation right is critical.

Insurance 255

Insurance 255

Forbes Healthcare

FEBRUARY 11, 2025

billion in 2024 profits that included a $693 million fourth quarter loss as the health insurer exits unprofitable Medicare Advantage markets. Humana Tuesday reported $1.2

Insurance 273

Insurance 273

Scrubs

AUGUST 19, 2023

If a patient is suing you – and it can happen more easily than you want to imagine – then personal malpractice insurance can come in handy. At the same time, you want to make sure you ask all the necessary questions to find out how much your employer’s insurance covers you. There’s another good reason why you need personal insurance.

Insurance 246

Insurance Medication 246

Forbes Healthcare

JUNE 13, 2024

The bureaucracy and opacity of hospital and insurance billing is impossible to navigate. But it doesn't have to be.

Billing 256

Billing Insurance Hospital 256

Forbes Healthcare

DECEMBER 15, 2024

With one exception, no insurer in our health care system wants to take on a sick person. The exception is Medicare Advantage.

Insurance 246

Insurance 246

Scrubs

MARCH 6, 2023

And lawmakers in Washington state have proposed a bill that would provide workers’ compensation insurance coverage for nurses with PTSD, similar to a 2018 law that provides workers’ PTSD compensation to firefighters and police officers. Low pay, long hours, and staff shortages have only compounded the crisis.

Billing 263

Billing Insurance Hospital 263

Forbes Healthcare

OCTOBER 2, 2024

Plus: Here’s how Epic founder and CEO Judy Faulkner will keep her medical records company private, independent and employee-owned forever.

Insurance 343

Insurance Medication 343

Forbes Healthcare

OCTOBER 17, 2024

Elevance Health is the latest health insurance company to report higher-than-expected medical costs as third quarter profits fell more than 20%.

Insurance 218

Insurance Medication 218

Forbes Healthcare

JUNE 3, 2024

Most of us need cash more than comprehensive plans. The goal of equalizing medical spending cannot justify forcing everyone to pay for the same expensive coverage.

Insurance 287

Insurance Medication 287

Forbes Healthcare

MAY 15, 2024

Livongo cofounder Glen Tullman wants to help employers lower healthcare costs with AI, but it may be just another Band-aid for America's $4.5 billion healthcare bill.

Insurance 354

Insurance Billing 354

Forbes Healthcare

FEBRUARY 3, 2025

Going forward, we may see more instances in which insurers deny or (temporarily) severely restrict coverage of accelerated approvals, as Independence Blue Cross has done.

Insurance 200

Insurance 200

Forbes Healthcare

FEBRUARY 27, 2025

Blue Cross Blue Shield has controlled the Alabama health insurance market. AFLA is creating a new insurance but are they playing by the rules? What patients need to know

Insurance 153

Insurance 153

Forbes Healthcare

FEBRUARY 13, 2025

Resentment toward insurance companies is not inevitableits a symptom of a broken system. With their reputations so damaged, how can payers rebuild trust with consumers?

Insurance 151

Insurance 151

Forbes Healthcare

MARCH 21, 2025

While the number of prescription fills for GLP-1 receptor agonists has continued to increase, health Insurance coverage for meds like Ozempic and Zepbound has decreased.

Insurance 130

Insurance 130

Forbes Healthcare

OCTOBER 18, 2024

The causes of today’s rising healthcare prices are rooted in decisions made 15 years ago with the passing of the Affordable Care Act of 2010.

Insurance 287

Insurance 287

Forbes Healthcare

JANUARY 16, 2025

The December murder of Brian Thompson has left the industry grappling with how so much anger could be directed towards a sector that purports to keep people healthy.

Insurance 263

Insurance 263

Forbes Healthcare

FEBRUARY 17, 2025

Elevance Health says its acquisition of Verilys Granular Insurance is designed to bolster its offerings to self-funded employer clients.

Insurance 145

Insurance 145

Forbes Healthcare

JULY 24, 2024

Medicare Advantage is accounting for “a rising share of inpatient hospital days,” according to a new KFF study shows.

Admissions 244

Admissions Hospital Insurance 244

CollaborateMD

MARCH 20, 2025

Whether you’re a physician starting a practice or a healthcare provider working to expand patient access, getting medical insurance credentialing is vital. RELATED ARTICLE: Optimizing Insurance Payer Reimbursement with RCM Services What is Medical Insurance Credentialing? Let’s dive in.

Insurance 52

Insurance Medication Follow-Up Billing 52

KevinMD.com

FEBRUARY 6, 2025

With the murder of the UnitedHealthcare CEO, many have expressed vitriol towards the insurance industry. Having worked in non-profit health care all my life, I decided in 2018 to switch to the “dark side,” or the insurance industry, out of curiosity. What is it that they do, and how are they doing it?

Insurance 61

Insurance 61

Healthcare Dive - Practice Management

NOVEMBER 18, 2024

In the third quarter, the seven major publicly traded insurers’ medical loss ratios increased an average of 3.3 percentage points year over year — a major jump in medical costs.

Insurance 133

Insurance Medication 133

Forbes Healthcare

MARCH 18, 2024

There’s no denying that prescription opioids can be misused, abused, and diverted. And so, given these risks, there’s a desire for novel non-opioid treatments.

Insurance 272

Insurance 272

Forbes Healthcare

AUGUST 15, 2024

Insurers like UnitedHealthcare, Aetna and Cigna pay for Equip's specialized virtual eating disorder therapy for kids and adults.

Insurance 363

Insurance 363

Healthcare Dive - Practice Management

OCTOBER 25, 2024

MultiPlan, which denies the allegations, has been sued dozens of times over concerns the company is conspiring with health insurers to underpay doctors for out-of-network care.

Insurance 129

Insurance 129

Forbes Healthcare

APRIL 3, 2024

Some payers are imposing further restrictions or eliminating coverage of GLP-1 drugs while either maintaining access to bariatric surgery or making it easier to obtain.

Insurance 217

Insurance 217

Healthcare Dive - Practice Management

FEBRUARY 25, 2025

Operating income fell for all but two insurance divisions operated by major payers in the fourth quarter. And 2025 may be no better, after many major payers released outlooks suggesting medical costs will continue climbing this year.

Insurance 99

Insurance Medication 99

Forbes Healthcare

AUGUST 7, 2024

CVS Health CEO Karen Lynch is taking over “day-to-day management” of the company’s Aetna health insurance business after its latest poor performance.

Insurance 333

Insurance 333

Emerging RN Leader

MARCH 12, 2025

A declining economy also threatens the jobs of a significant number of workers in the US and, with it, their health insurance. Sherman, EdD, RN, NEA-BC, FAAN Health systems are facing serious headwinds this year with potential cuts to Medicare, Medicaid, and the federal subsidy of health exchanges.

Insurance 142

Insurance Communication 142

KevinMD.com

FEBRUARY 17, 2025

5 essential questions about your NP liability insurance originally appeared in KevinMD.com. However, when the patient’s worsening condition later revealed an elevated white blood cell count, they were rushed for further evaluationbut it was too late. The patient succumbed to Read more Are you protecting your career?

Insurance 69

Insurance Discharges Tests 69

Forbes Healthcare

MAY 8, 2024

Plus: After more than a decade in the red, health insurer Oscar Health has a profitable quarter.

Insurance 327

Insurance 327

Forbes Healthcare

MARCH 28, 2024

When an individual files a medical insurance claim, they expect swift processing, approval, and treatment from the stakeholders involved.

Medication 327

Medication Insurance 327