The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

Agentic AI can connect historical behavior, evolving utilization signals and payment integrity requirements into a single control framework that adapts over time.

NASHVILLE, Tenn., Feb. 19, 2026 /PRNewswire/ -- Shearwater Health, a leader in clinician-led clinical outsourcing solutions, announced today that it earned a three-year Utilization Management (UM) ...

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A new analysis by researchers from the Harvard Pilgrim Health Care Institute examines the first Centers for Medicare and Medicaid Services (CMS) add-on code targeting a single physician specialty: ...