Tag: Humana

The Impact of AI on Medicare Advantage Claims Denials

Angela Linders
Medicare Advantage Claims Denials

A Growing Concern for Healthcare Providers In recent years, the integration of artificial intelligence (AI) in the healthcare sector has sparked significant debate, especially concerning its role in Medicare Advantage claims denials. As hospitals face mounting administrative burdens, the use of AI by insurance companies has been scrutinized for potentially prioritizing cost-saving measures over patient care. The Rise of AI in Insurance Between 2019 and 2022, insurance companies like UnitedHealthcare, Humana, and CVS began increasingly employing AI tools to automate the prior authorization process. These technologies, while designed to streamline…

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Cigna insurance company ends its Humana acquisition intentions

Logan B.
Insurance Company - Acquisition Cancelled

The insurer is now developing a $10 billion share buyback plan after a failure to agree on a price. Health insurance company Cigna has ceased its pursuit of a negotiation for acquisition of its rival insurer Humana. The company left its efforts when the two insurers were unable to agree on price. Cigna announced that it is working on plans for buying back $10 billion worth of shares. The health insurance company resulting from an acquisition of Humana by Cigna would have resulted in an insurer with an estimated value…

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Humana is leaving Colorado’s small business health insurance market

Nordstrom
Health Insurance - Exit Sign

The insurer has announced that it will be exiting the employer group marketplace within 18 months. Small business health insurance provider Humana has announced that it will be stepping out of the state’s employer group market within the next 18 months. The announcement was first made in a letter the insurer issued to brokers and agents in the state. While the letter was a formal announcement to the brokers and agents who sell Humana’s health insurance policies, at the time this article was written, the insurer had yet to officially…

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Walmart health insurance acquisition talks underway with Humana

H. Cutner
Walmart Health Insurance - Insurance Company Acquisition - Business

The largest retail chain in the world is reportedly in early-stage negotiations with the insurer. A new Walmart health insurance company may one day form if its acquisition of Humana is successful. The Wall Street Journal reported that the retailer was in talks with the insurer for precisely that purpose. Reuters soon after reported that the companies were working on a possible partnership without ruling out an acquisition. Humana’s shares skyrocketed by up to 13 percent during the trade hours following the reports. The Walmart health insurance talks also gave…

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Kentucky insurance exchange offers only one option for many health plan shoppers

Marc
kentucky insurance exchange

Residents of several of the state’s counties will have only one coverage option to choose next year. The Kentucky insurance exchange will continue to have health plan options for consumers across the state. That said, residents of some counties will have only one coverage option to buy. The recently released county level map of the state illustrated the 2018 health insurance company participation. That said, despite the fact that some people have exceptionally limited options on the Kentucky insurance exchange, they are considering themselves lucky when compared to counties in…

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Humana intends to step out of Affordable Care Act insurance exchanges

Nordstrom
affordable care act health insurance coverage

The health insurer announced that it would no longer be selling individual plans on the public marketplace in 2018. Humana announced that it would no longer sell health insurance through the exchanges created through the Affordable Care Act. It will be withdrawing from the marketplace in 2018. With this withdrawal comes the first exit from the exchanges by a major health insurance company. As could be expected, President Trump grabbed the opportunity to tweet about the Affordable Care Act. He said Humana’s withdrawal was further evidence that The ACA needed…

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Insurance company merger between Aetna and Humana will not go forward

H. Cutner
Health Insurance company merger Aetna

A federal judge has now ruled in favor of prohibiting the two health insurers from merging. The Justice Department’s decision to stop the insurance company merger between Aetna and Humana has been upheld by a federal judge. These two health insurance giants were appealing the decision with U.S. District Judge John. D. Bates. The original decision to block the merger between the health insurance companies occurred in July 2015. That said, Judge Bates concluded in a 158-page opinion that “The Court is unpersuaded that the efficiencies generated by the merger…

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