Clients of the drug middleman can pay monthly fees per member that aren’t linked to manufacturers’ list prices or ...

UnitedHealth Group's pharmacy benefit manager, Optum Rx, is making the shift to a more transparent model, the company ...

ICD-10 coding’s complexity can slow even experienced professionals, but modern tools are changing the game. From simple keyword searches to integrated AI encoders, these solutions help coders work ...

Optum is combining AI, automation, and workflow intelligence to improve healthcare payment accuracy, reduce costly errors, and strengthen provider-payer collaboration. By integrating claims, coding, ...

Adoption metrics show a wide gap between declared AI priority and production deployment in health care, compounded by limited ...

Optum Real, a real-time claims system that instantly connects payers and providers, is partnering with Microsoft to speed the claims and reimbursement process. The partnership combines Optum's ...

This story is part of a Seattle Times focus on the affordability crisis in the Northwest. We explore the high cost of living and wealth disparities that shape our region; examine policies that impact ...

A California man was accused of hiring a friend for a fictitious position and receiving a portion of wages from the no-show job via kickbacks. A Minnesota jury has found a former senior director at ...

The Minnesota Department of Human Services (DHS) has begun “enhanced prepayment review” of Medicaid service programs, according to an update from state officials on Monday. More than 80,000 claims ...

Vertical integration between insurers and providers is rapidly reshaping US health care, with acquisitions by UnitedHealth Group’s Optum division playing a significant role. This study examined two ...