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Mitigate your insurance claims nightmare
Rajiv Ronanki Previously Senior Vice President responsible for many digital initiatives Elevance Healthbecame CEO. lyricsSo he wants to help transform the chaotic world of insurance claims into a more user-friendly one with the help of hype technologies like AI.
“We’ve been talking about things like consumer transparency for nearly a decade, but we haven’t made much progress,” he told me.
Until recently, Lyric was called: Claim Xtena billing compilation business that was formerly a subsidiary changing healthcare. ClaimsXten sold to private equity firm TPG Capital Pay $2.2 billion to ease heavy regulatory scrutiny united health groupAcquisition of Change by.
At the time of the sale, ClaimsXten partnered with 9 of the top 10 insurers, only 9 are missing united health care — Helping healthcare providers make accurate and efficient payments, giving the company deep visibility into millions of healthcare transactions. Ronanke sees this as an opportunity to improve the patient experience with insurance claims, including the confusing “this is not a bill” mailing.
“We have the rules and we have all the knowledge of how trades should be settled,” he told me. “So we can take that knowledge and combine it with new machine learning and AI technologies to really make life easier and simpler for consumers.”
Ronanke envisions that the company could launch a large language model within a year or so that can answer questions about bills and potential care costs. The service will be available to members with health insurance, but a more widely available version may be created. Lyric will remain primarily a business-to-business service, but “consumers will be the primary beneficiaries of the seamlessness and frictionlessness,” he said.
How FDA’s Pandemic Flexibility Has Spurred Mental Health App Development
last year, wrote about how in times of pandemic Food and Drug Administration The enforcement policy allowed mental health app developers to experiment with treatments in the real world without seeking marketing approval. With the formal public health emergency ending today, these companies have until early November to apply for FDA approval or exit the market. in a new storyI checked in with two companies, big health and Rimbixabout their plans.
- Two products from Big Health, Dawntreat anxiety, and Three PioA product to treat insomnia was actually marketed before the enforcement policy, but the company used its flexibility to position the product more aggressively as a treatment. CEO Arun Gupta He said it has treated more than 150,000 patients since the pandemic began, which he believes is part of the company’s ability to make stronger claims about its products. Now Big Health has to decide whether to keep the treatment and seek approval or scale back.
- Meanwhile, Limbix, which develops an app to treat young people with depression, is using that flexibility to: Spark Rx Despite only preliminary efficacy data.Chief Scientific Officer Jessica Lake SparkRx serves patients in 39 states, with half of its visits coming from primary care providers, with the highest number of visits from local and regional health centers, and the “existing access challenges and , highlighting the ability of digital therapeutics to fill critical gaps in care.”
- Lake also said that Limbix recently completed data collection for its pivotal trial and plans to submit SparkRx for regulatory approval by the November deadline. Lake gave me an early look at statistically significant data.
Please see here for the detail.
Google and IBM Strengthen Generative AI Plan
Google I am training a generative AI system. Medpalm 2, which provides functionality around imaging data such as X-rays and mammograms, and helps communicate with physicians about data used routinely in patient care. The move highlights a broad push to make these models habituated to work with the different types of data that clinicians need to use in real-world medicine, from genetic sequences to billing codes. . Greg CollardA senior researcher at Google, Casey spoke to Casey about the opportunities presented by rapid advances in AI and the risks of moving too fast. Read full text.
Speaking of moving fast IBM, Which failed badly In the AI competition over deep learning, announced a new platform called Watson X Helping companies in multiple industries incorporate generative AI into their business. CEO of the company, Arvind KrishnaHe said the low cost of implementing a large language model will quickly attract a wide variety of new users. Who knows if it will get better or worse.
Data on Digital CBT and Diabetes
This week, we saw new data from two different collaborations between digital health startups and more traditional healthcare companies.
- Magellan Health and neuroflow published data about The company’s year-old Digital Emotional Wellbeing suite combines Magellan’s digital CBT modules with NeuroFlow’s software infrastructure to enable diagnosis, triage and patient access. A user who completed more than his 75% of the FearFighter module saw an average 41% reduction in anxiety rating scores. Data is extracted from a sample of hundreds of users. Although these are promising results, the samples are very selective, so we will focus on additional details later when published.
- Next, Sanofi and Dario Health public data Users of Dario’s Diabetes Solution show a 9% reduction in all-cause medical resource utilization and a 24% reduction in hospitalizations compared to non-users. A retrospective cohort study used statistical methods to compare 2,445 Dario users with 7,334 nonusers. This is the first of several studies being conducted as part of the strategic partnership between Sanofi and Dario.Lawmakers criticize CMS for breakthrough device
At yesterday’s hearing, lawmakers called for a simpler redemption pathway. Breakthrough designated devicereiterates the common claim by medical device makers that when companies struggle to get insurance coverage, it stifles innovation and limits patient choice.
Republicans called CMS If it took two years to announce a rule to replace Trump-era policies that were rescinded in 2021, that rule would have been a guarantee. FDA– Designated breakthrough devices have 4 years of Medicare coverage. However, CMS is subject to different and often higher data standards than the FDA for devices. STAT is approved by the FDA breakthrough device programis intended to benefit patients, brought maximum profit For device companies.
There was just one call for attention to automatically granting coverage for breakthrough devices. Congressman Lloyd Doggett (D-Tex.), stressed safety and efficacy concerns, and raised questions about the quality of data from groundbreaking device research. Please see here for the detail.
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