Articles

As AI accelerates billing errors and inflated claims, health plans need targeted AI solutions to protect payment integrity and stay ahead of emerging risks.

Here’s what to look for in a healthcare payment integrity vendor so you can cut through the noise and make a confident, informed decision.

A deep-dive into T1019 personal care overpayments and why New York could be the epicenter of Medicaid's single largest fraud, waste, and abuse exposure.

When people say the U.S. healthcare system is “broken,” they’re usually pointing to one core issue: rising costs. But at Alaffia, we know the deeper problem is that too much healthcare spending never reaches the patients it’s meant to serve.

The sharp rise in Sepsis DRG coding and reimbursement has emerged as one of the most prevalent billing challenges facing health plans today. 

Alaffia's AI team analyzes DeepSeek-R1's breakthrough performance and explains why specialized clinical datasets and domain expertise remain crucial for effective health plan claims operations, despite advances in general AI models.

Explore how new legislation aims to fast-track Medicare coverage for breakthrough devices and obesity treatments, and why payers should adopt advanced tech solutions to stay ahead of faster approvals and reimbursement changes.

Explore how healthcare payers can defend against the rising wave of ransomware attacks and prevent costly overpayments with proactive strategies and next-gen AI technology.

Explore how healthcare consolidation, rising facility fees, and evolving state laws impact claims processing—and how Alaffia’s AI-powered solutions help payers ensure billing accuracy and control costs.