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 ...

Navitus, the nation’s first and largest transparent, pass-through pharmacy benefit manager (PBM), today announced the expanded implementation of Banjo Health. Banjo is an advanced automation platform ...

JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, successfully implemented its Intelligent Utilization Management, solution with a large ...

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

Panelists discuss how utilization management limits clinical autonomy and advocate for reforms that preserve shared, patient-centered decision-making. Panelists discuss how increasing utilization ...

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 ...

MCLEAN, Va., April 26, 2023 /PRNewswire/ -- The Virginia Department of Medical Assistance Services (DMAS) has awarded Keystone Peer Review Organization, LLC (Kepro), a subsidiary of CNSI, a $113 ...