Artificial Intelligence Boosts Authentic Learning in Higher Education

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insurance denials
From Peer-to-Peers to Paper Wars: Inside the Daily Grind of Fighting Insurance Denials
December 3, 2025

Insurance denials have quietly become one of the most powerful forces shaping American healthcare, not through better outcomes but through a steady tightening of what insurers are willing to cover and when they’ll say so. The real scandal isn’t just that claims get rejected—it’s that the system rewards obstruction, pressuring hospitals to spend…

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healthcare
Navigating the Power Differential: A Physician’s Perspective
December 2, 2025

Healthcare in the U.S. often feels less like a covenant and more like a negotiation conducted on a tilted table, where insurers hold the rulebook and patients hold the receipt for their pain. The “two-midnight rule” and similar fixes were meant to tame arbitrary denials, yet the system keeps sprouting fresh loopholes because…

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care
Navigating the Denial Pipeline: How Medicare Advantage Plans Reshape Access to Care
December 2, 2025

Medicare Advantage was sold as a smarter, more efficient way to care for seniors, but too often the efficiency seems to land on the wrong side of the patient–provider relationship. When plans deny or delay needed services through opaque rules and weak oversight, beneficiaries feel it first—in missed therapies, postponed procedures, and a…

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patient
Rebecca Interview: When Peer-to-Peer Reviews Stop Being About the Patient
December 2, 2025

Behind the sterile labels of “inpatient” versus “observation” care is a messy reality: clinicians and insurers often enter peer-to-peer reviews without a shared rulebook, turning what should be a clinical dialogue into a box-checking exercise. The speaker’s frustration points to a broader problem in U.S. healthcare utilization management—decisions about coverage can feel pre-decided,…

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