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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant

Aspirion Acquires Boost Healthcare to Enhance RCM Capabilities

by Fred Pennic 12/19/2024 Leave a Comment

Aspirion Acquires Boost Healthcare to Enhance RCM Capabilities

What You Should Know:  - Aspirion, a provider of healthcare technology revenue cycle management (RCM) solutions, today announced the acquisition of Boost Healthcare, a revenue cycle firm that joins revenue cycle leaders on their journey to improve their organization’s financial performance. Financial details of the acquisition were not disclosed. - The strategic acquisition strengthens Aspirion's commitment to helping healthcare providers secure accurate and timely reimbursement for
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4 Cornerstones for Successful AI Implementation in Hospital Revenue Cycle Management in 2025

by Jim Bohnsack Chief Strategy Officer at Aspirion 12/10/2024 Leave a Comment

4 Cornerstones for Successful AI Implementation in Hospital Revenue Cycle Management

In recent years, payers have increasingly turned to artificial intelligence (AI) as a tool to streamline claims processing, accelerating the deployment of rules related to prior authorizations and medical-necessity assessments. Providers believe this has been a key driver behind a corresponding surge in claims denials, as well funded payers leverage technology to rapidly render these determinations and send them back to hospitals. This trend has providers looking to respond with a
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Cofactor AI Nabs $4M to Combat Hospital Claim Denials with AI

by Syed Hamza Sohail 11/25/2024 Leave a Comment

Cofactor AI Launches Platform to Help Hospitals Fight Tidal Wave of Claims Denials and Announces $4 Million Seed Round

 What You Should Know: - Hospitals across the country are facing an ever-increasing onslaught of claims denials from insurance companies, with denials up 20.2% in 2023, according to the American Hospital Association. These denials – triggered by AI and often error-prone – cost hospitals $20 billion a year in administrative bloat and reduce patients’ access to quality care. - To help hospitals fight back, Cofactor AI today introduced a new first-of-its-kind AI-powered
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Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care

by Steve Kim, CEO of Valer 11/21/2024 Leave a Comment

Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care

As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior Authorization Physician Survey, 1 in 4 physicians report that prior auths “have led to a serious adverse event for a patient in their care.” Think about the toll that this takes on professionals whose primary job is providing lifesaving care, and the thing preventing this care is outside their
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Tassat, Veuu Partner to Streamline Healthcare Claims and Payments with Blockchain

by Syed Hamza Sohail 11/21/2024 Leave a Comment

Tassat, Veuu Partner to Streamline Healthcare Claims and Payments with Blockchain

What You Should Know: - Tassat Group, Inc., the leading provider of private permissioned blockchain-based real-time settlement solutions, today announced its strategic partnership with Veuu, an innovative AI-powered healthcare fintech company, to improve the inefficiencies and opaqueness plaguing the healthcare claims and payment process.  - Leveraging Tassat’s smart contract capabilities, this collaboration empowers Veuu with a solution to provide greater confidence in the traceability
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Thoughtful AI Launches AI Agents to Optimize Revenue Cycle Management

by Fred Pennic 11/20/2024 Leave a Comment

Thoughtful AI Launches AI Agents to Optimize Revenue Cycle Management

What You Should Know:  - Thoughtful AI, an innovator in AI-powered revenue cycle transformation, has announced the launch of its comprehensive team of specialized AI Agents for revenue cycle management (RCM).  - By optimizing back-office operations and reducing delays in billing, approvals, and claims processing, Thoughtful AI enhances the patient experience. This leads to faster access to care, fewer billing errors, and improved transparency regarding out-of-pocket
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HealthEdge, Codoxo Partner for GenAI-Driven Payment Integrity

by Syed Hamza Sohail 11/15/2024 Leave a Comment

HealthEdge, Codoxo Partner for GenAI-Driven Payment Integrity

What You Should Know: - HealthEdge® and Codoxo announce a strategic partnership to provide healthcare payers with the industry’s most cutting-edge solutions and services. -  This partnership will streamline and enhance their respective end-to-end payment integrity processes by leveraging HealthEdge Source™ in conjunction with Codoxo’s GenAI-driven Unified Cost Containment Platform. By joining forces to deliver an end-to-end payment integrity solution, healthcare payers will benefit from
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Bluespine Raises $7.2M to Combat Medical Overbilling with AI

by Fred Pennic 11/13/2024 Leave a Comment

Bluespine Raises $7.2M to Combat Medical Overbilling with AI

What You Should Know:  - Bluespine, an AI-driven claims cost reduction platform for self-insured employers, has secured $7.2M in seed funding to address the pervasive issue of medical overbilling in the US healthcare system led by Team8. - The seed funding will accelerate Bluespine's adoption by US employers and brokers, as well as support further research and development. Tackling the Healthcare Cost Crisis Bluespine was co-founded by a team of technology experts with deep
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Payment Integrity in Healthcare: Challenges and Solutions

by Prasanna Ganesan, CEO, Machinify 11/11/2024 Leave a Comment

Payment Integrity in Healthcare: Challenges and Solutions

Whether you work in healthcare or are just a patient who has interacted with the healthcare system, it shouldn't surprise you to read that healthcare costs have been going up and are expected to continue to do so into 2025 burdening all stakeholders. Despite the obvious need to cut wasted healthcare spending, research suggests that the industry as a whole isn’t very good at it, with administrative spending being one of the biggest culprits. One study found that nearly one-third of excess U.S.
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Q/A: Vim CEO Talks Solving the Rising Tide of Healthcare Claim Denials

by Fred Pennic 11/06/2024 Leave a Comment

Q/A: Vim CEO Talks Solving the Rising Tide of Healthcare Claim Denials

The U.S. healthcare system is grappling with a surge in claim denials and prior authorization requirements, creating significant challenges for both providers and patients. To shed light on this pressing issue, we spoke with Oron Afek, CEO of Vim, a company that assists over 20,000 providers and 80% of the largest U.S. payers with prior authorizations. In this interview, Oron Afek provides valuable insights into the challenges and potential solutions related to claim denials and prior
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