Tag: utilization management

Addressing Payer Denials and Utilization Challenges in US Healthcare

Explore challenges healthcare providers face with payer denials and audits and how solutions like PayerWatch's platform improve revenue protection and utilization management.

CMS Launches WISeR Model to Cut Overuse in Medicare with AI-Driven Prior Authorization

CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.

Study Reveals Insurance Red Tape Delays Cancer Care and Erodes Trust

Research shows administrative delays and insurance utilization management practices disrupt timely cancer treatment and increase patient distress, highlighting the need for systemic reform.