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As physicians, payers and independent reviewers all adopt AI for utilization review and No Surprises Act disputes, audit trails and human oversight will determine which practices come out ahead.

The license fee is the number on the proposal. These 10 costs arrive after the contract is signed, and the biggest never shows up on an invoice.

A NAACOS and Innovaccer survey of 116 leaders also found only 21% are tracking which of their patients have enrolled in the new chronic care model.

The CMS-0057 rule regulates health plans. The question that matters is: Which of your payers will be live in your EHR on Jan. 1?

The top news stories in medicine this week.

An OpenAI agent's unauthorized trip through an Australian Medicare data portal is a preview of the risks physicians take on as autonomous AI moves into prior authorization, billing and scheduling, and of what practices should demand from the vendors deploying it.

Adding a brief safety reminder cut potentially harmful clinical choices by large language models from 16.6% to 10.1% across more than 10 million responses, but researchers say it doesn't replace physician oversight.

What it takes for health systems and health plans to stay visible when an AI model is the one making the recommendation.