The Phia Group Blog
Welcome to The Phia Group Blog, your source for cutting-edge insights into health plans, cost containment, and industry regulations updates. We break down top stories and trends, share actionable strategies, and provide expert perspectives to help you stay ahead.
There Is No Finish Line with AI
By: Andre Cliff One thing I’ve learned from working very closely with AI is that there really isn’t a place of arrival. You don’t reach a point where the right model is in place, the right information has been added,…
Patients Before Monopolies Act
By: David Ostrowsky Already, 2026 has seen a spate of reforms passed for pharmacy benefit managers (PBMs), known for their role in coordinating drug manufacturers, pharmacies and insurance companies, and who preside over Rx benefits, negotiate prices of pharmaceuticals, process…
Building Plan Language Using Artificial Intelligence: Man vs. Machine
By: Kate MacDonald These days, artificial intelligence, or AI, has become increasingly incorporated into nearly all areas of our lives. You cannot turn a corner without encountering it, from the smartwatch strapped on your wrist relaying sleep metrics to your…
Doctors Not AI Act
By: David Ostrowsky While many healthcare organizations have lauded AI for its inherent potential to improve the US healthcare system by expediting claim review decisions, generating summaries of doctors’ conversation with patients, and analyzing scans and X-rays among other functions,…
AI, Healthcare Subrogation, and Prudent Recovery Administration
By: Stewart P. Miller, Esq. Every healthcare subrogation professional knows the file. Medical claims have been paying for months, and nothing initially distinguishes them from thousands of other claims in the system. Then a questionnaire, diagnosis code, provider note, or…
As IDR Volume Grows, Experience Matters
By: David Ostrowsky The No Surprises Act (NSA) established a federal framework intended to protect patients from surprise medical bills while also providing a structured process for resolving payment disputes between payers and out-of-network providers and facilities. As the volume…
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