In 1971, a small team at Boston’s Beth Israel Hospital, led by Dr. Howard Bleich and Dr. Warner Slack, booted up the hospital’s first Center for Clinical Computing. Their PDP-11 minicomputer stored lab results and a few hundred ICD-8 codes on nine-track tape. Each evening, residents lined up to run charge‐slip reports and marvel at the glow of the terminal. Fifty years later, we still tabulate charges, but the code set has grown from those few hundred entries to nearly 70,000 in ICD-10-CM,
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Waystar to Acquire Iodine Software for $1.25B, Enhancing AI-Powered Healthcare Payment Solutions
What You Should Know:
- Waystar, a provider of healthcare payment software announced a definitive agreement to acquire 100% of Iodine Software (“Iodine”) for $1.25B.
- The proposed acquisition is expected to significantly accelerate Waystar’s ability to transform healthcare payments through its leading cloud-based software platform, empowering more than one million providers with advanced AI capabilities to prevent denials, reduce manual work, and improve financial
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UnitedHealth Group Under DOJ Probe: Medicare Billing Practices Face Criminal & Civil Investigation
What You Should Know:
- UnitedHealth Group revealed it is facing a Justice Department (DOJ) criminal and civil investigation into its Medicare billing practices, adding to a series of recent setbacks for the nation’s largest and most powerful private insurer.
- The company also announced it has launched a third-party review of its business policies and performance metrics, expected to be completed by the end of the third quarter. The announcement comes after a tumultuous period for
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Humana Accelerates Prior Authorization Reforms, Pledges to Cut Requirements and Expedite Approvals
What You Should Know:
- Humana Inc. announced accelerated efforts to approve care requests as quickly as possible and reduce the administrative burden for physicians associated with prior authorization.
- These actions aim to streamline and reduce prior authorization requirements while preserving the system of checks and balances that protects patient safety for high-cost, high-risk treatments.
Prior Authorization Reform
Humana is working to reduce the "red tape" on prior
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TechMatter Acquires DoctorPapers to Expand Healthcare Revenue Cycle Management Services
What You Should Know:
- TechMatter, a leading provider of enterprise healthcare and automation solutions, acquires DoctorPapers, a California-based medical billing and revenue cycle management (RCM) company. This strategic move reinforces TechMatter’s mission to deliver scalable, tech-driven healthcare operations to providers across the United States. Financial details of the acquisition were not disclosed.
- Founded in 2020, DoctorPapers has built a strong reputation for delivering
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Charta Health Secures $22M to Automate Medical Billing and Clinical Documentation with AI
What You Should Know:
- Charta Health, an AI-powered platform that automates and optimizes medical billing and clinical documentation workflows secures $22M in Series A funding round led by Bain Capital Ventures, with participation from Madrona, SV Angel, Refract Ventures, and South Park Commons.
- The U.S. healthcare system loses over $300 billion each year due to billing errors, undercoding, and preventable claim denials. This significant financial drain often stems from slow,
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PwC Report: US Medical Cost Trend to Remain Elevated at 8.5% in 2026
What You Should Know:
- The U.S. healthcare system is entering 2026 with medical cost trends reminiscent of 15 years ago, facing persistent inflationary forces and significant federal policy changes, according to a new report from PwC.
- The report, "Medical Cost Trend: Behind the Numbers 2026," projects the Group medical cost trend to remain at 8.5% in 2026 (the same level as 2025) and the Individual market trend at 7.5%. Pharmacy costs are a particular concern, projected 2.5
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Methodist Le Bonheur Selects Ensemble as Strategic RCM Partner
What You Should Know:
- Ensemble, a revenue cycle managed services partner for healthcare organizations, announced that Methodist Le Bonheur Healthcare (MLH) has selected it as its strategic revenue cycle management (RCM) partner.
- Ensemble will assume full responsibility for end-to-end revenue cycle operations across all six hospitals in the Memphis-based health system, bringing advanced technology, deep operational expertise, and a shared commitment to delivering exceptional
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ZeOmega Partners with Massachusetts Health Data Consortium to Launch Nation’s First Statewide FHIR-Based Prior Authorization System
What You Should Know:
- ZeOmega®, a population health and interoperability technology company announced it has been selected by the Massachusetts Health Data Consortium (MHDC), a nonprofit advancing health data sharing, to transform prior authorization and clinical data exchange across Massachusetts.
- The initiative creates the nation’s first statewide FHIR®-based system designed to streamline communication between payers and providers, reducing administrative burdens and
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What Are Healthcare’s Most Pressing Revenue Integrity Issues in The Remote-Work Era?
With more and more organizations merging for scale and sustainability, revenue cycle teams are being centralized, taking these critical personnel further away from physicians at the bedside. Remote teams are finding it harder than ever to collaborate with clinicians on critical functions.
Simultaneously, more revenue cycle functions are being automated as robotic process automation and generative AI evolves. With fewer administrative personnel in general — and even fewer
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