What You Should Know: - Availity today announced a definitive agreement to acquire the utilization management solution and business unit from healthcare automation company Olive AI, Inc. Financial details of the acquisition were not disclosed. - The acquisition of Olive AI's utilization management solution offers numerous benefits for Availity’s national network of payers and providers. These include lower administrative and medical costs, improved patient access
Read More
Availity
AGS Acquires Offshore Patient Access BPO Unit from Availity
What You Should Know: - AGS Health, a provider for tech-enabled revenue cycle management (RCM) solutions announces the acquisition of the India-based patient access outsourcing business unit of the Florida-based healthcare technology company Availity. - With more than half of U.S. hospitals anticipating a year of negative margins, achieving full and accurate reimbursement for services has never been more critical. With this expansion, AGS Health is positioned to provide faster, more
Read More
9 Executive Revenue Cycle Predictions/Trends to Watch in 2023
Nate Maslak, the co-founder/CEO of Ribbon Health Price Transparency: In 2022, we saw CMS’s Transparency in Coverage rule go into effect, requiring non-hospital entities like health plans and providers to publish publicly available rates for care. In 2023, we’ll see this price transparency data become more mainstream as it finally makes its way into the hands of patients, empowering them to find the best care for them, reevaluate their care choices, and shop around for the best possible care
Read More
Availity to Acquire Diameter Health to Expand Clinical Data Interoperability
What You Should Know: - One of the nation’s largest real-time health information networks Availity announced an agreement to acquire Diameter Health, a national leader in clinical data quality and interoperability. - This strategic deal expands Availity’s clinical portfolio to deliver the strongest integrated clinical and claims data network and interoperability platforms in healthcare. Streamlining Clinical Data Interoperability Founded in 2013, Diameter
Read More
Executive Roundtable: Can Innovation Alleviate Clinician Burnout?
The U.S. Surgeon General’s recent advisory about clinician burnout cited numerous societal, cultural, structural, and organizational causes—including excessive workloads, administrative burden, and lack of organizational support. The potential fallout of this trajectory is alarming: The advisory cites the Association of American Medical Colleges’ estimate on clinician demand outpacing supply, with an anticipated shortage of between
Read More
4 Quick Tips for Getting COVID-19 Claims Paid Promptly
As the COVID-19 pandemic has gripped the world, many providers have adopted an all-hands-on-deck approach and mentality for treating COVID-19 patients, stretching their resources to the breaking point. We have heard about the frontline heroes who have sacrificed their own health and safety to treat patients and, in less-fortunate scenarios, comfort patients in their last moments as they were quarantined from loved ones. What has been less recognized is the work and sacrifice
Read More
Open APIs in Healthcare: The Future of Data Integration Report
What You Should Know: - The latest Chilmark Research report examines how data-oriented APIs are contributing to development and integration efforts across healthcare from the perspective of the developer. - Reeling from the impact of the COVID-19 pandemic and seeking more effective ways to implement new functionality, healthcare enterprises of all kinds are looking to alternatives for prevailing development and integration practices. Unlocking value from the data scattered across
Read More
Why Outsourcing is the Best Approach to Prior Authorizations
Doctors didn’t attend medical school to spend their waking hours managing or waiting for prior authorizations (PA), but these days it feels like that’s all they are doing. A recent American Medical Association survey found that 90 percent of responding physicians believe that the “administrative burden related to PA requests has risen in the last five years, with most saying it has ‘increased significantly.’” As healthcare continues its acceleration toward value-based reimbursement models,
Read More
Social Distancing: Addiction Recovery Programs Go Virtual for COVID-19
We have been following the social distancing guidelines for two weeks now with more weeks to go. One population that truly needs and is literally prescribed social interaction is that of Substance Use Disorder (SUD). In fact, the 12 step (recovery approach) community, relies on being social wherein attending group meetings to share experience, strength, and hope is a part of the proven philosophy. Turns out, social distancing while helpful with the COVID-19 crisis is creating another one;
Read More
How Multi-Payer Portals Incent Providers to Better Manage Their Data
Mark Martin, Director of Payer Solutions for Availity Value-based healthcare demands meaningful payer-provider collaboration. However, burdensome administrative processes and inefficient solutions stunt the ability of payers and providers to share data, manage risk, validate credentials, process claims, control costs and optimize the consumer experience. These information bottlenecks are most acute in the area of provider data management (PDM). Each year, payers and providers spend more than
Read More
