Anyone who receives a hospital, medical imaging, or outpatient surgery bill is usually surprised at the cost.
No matter the cost, how do they know the bill is correct? They don’t.
Incorrect medical bills have become so prevalent that organizations have started applying technologies like artificial intelligence (AI) and machine learning to reduce drastically high healthcare costs.
Consider what organizations as diverse as the Office of the Inspector General, Harvard
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Denials Management Named Most Time-Consuming Task in RCM
What You Should Know:
A new HFMA survey commissioned by AKASA highlights the revenue cycle tasks requiring the most subject matter expertise, according to responses from over 550 CFOs and revenue cycle leaders at hospitals and health systems across the U.S.Denials management not only requires the most subject matter expertise, but it’s also the most time-consuming task within revenue cycle management (RCM) — followed by prior authorization and insurance
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How Health Payment Accounts Improve Health Equity
In 2022, 38 percent of Americans reported delaying medical care—a 20-year high. But as with many things, the burden of paying for healthcare doesn’t affect all Americans equally.
Lower-income communities, for example, tend to have higher incidences of disease and therefore a greater need for healthcare. And in a vicious catch-22, those with lower incomes, Black and Hispanic adults, and women often have health benefits mis-sized to their income, which contributes to higher incidences of
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FWA Is Increasing. Healthcare Costs Are Spiraling. Now There’s A New Generation Of AI Technology To Take Back Control
In 2020, the Department of Justice estimated that fraudulent, wasteful, and abusive (FWA) billing practices account for more than $100 billion of the nation’s healthcare expenditures.1 Today, the National Healthcare Anti-Fraud Association (NHCAA) conservatively estimates that healthcare FWA costs the nation about $68 billion annually, representing 3% of the nation's $2.26 trillion in healthcare spending.2 FWA estimates from commercial health plans range as high as $230 billion annually, or
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Inbox Health Raises $22.5M for Patient Billing Communications Platform
What You Should Know:
Inbox Health, a New Haven, CT-based patient billing communications platform raises $22.5M in a Series B financing round, led by fintech-focused Ten Coves Capital. The Series B announcement follows news that Inbox Health's billing technology was awarded a patent by the U.S. Patent and Trademark Office in April 2023. The new growth capital will further accelerate Inbox Health’s strategic growth as it continues to improve and modernize the billing, support, and payment
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Sagility Acquires Payment Integrity Provider DCI Consulting
What You Should Know:
Sagility, a provder optimizing the member/patient experience and business process management acquires Chandler, Arizona-based Devlin Consulting, Inc. (DCI), an established healthcare technology services company with nearly 30 years of payment integrity experience.The acquisition represents Sagility’s first acquisition since unveiling its new identity as an independent U.S.-based company solely dedicated to the healthcare industry following the 2021 divestment from HGS.
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ClaimsXten Rebrands as Lyric, Appoints Raj Ronanki as CEO
What You Should Know:
- ClaimsXten Portfolio, a claims editing software business owned by TPG Capital, today announced it has rebranded as Lyric.
- In addition, the company announced the appointment of Raj Ronanki as Chief Executive Officer. Ronanki most recently served as Senior Vice President of Elevance Health and President of Carelon Digital Platforms. Carolyn Wukitch, who has served as CEO of the company, formerly known as ClaimsXten Portfolio, will continue in a leadership role as
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Availity Acquires Olive AI’s Utilization Management Solution and Business Unit
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
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Medical Coding Market to Reach $15.3B by 2033, Report Finds
What You Should Know:
- The medical coding market is estimated to secure a valuation of $ 6.7B in 2023 and is estimated to rise to $15.3B by 2033 at a CAGR of 8.6% during the 2023 to 2033 forecast period, according to a new Future Market Insights report.
- The increasing availability of a large number of medical coding service providers and the rising adoption rate of advanced healthcare solutions like electronic health records (EHRs), revenue cycle management (RCM) software, and mobile
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Catholic Care Center to Deploy Medsphere’s Wellsoft EHR and RCM Cloud Solutions
What You Should Know:
- Medsphere Systems Corporation announced that Catholic Care Center of Bel Aire, Kansas, a Wichita suburb, will open a new senior behavioral health hospital with the company’s Wellsoft electronic health record (EHR) and RCM Cloud revenue cycle management solutions.
- Medsphere’s Wellsoft EHR solution supports comprehensive care across behavioral health, urgent, and emergency care environments. The company’s RCM Cloud solution is
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