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

Waystar Launches AltitudeAI to Combat Claim Denials with AI-Powered Automation

by Syed Hamza Sohail 01/15/2025 Leave a Comment

Waystar Launches AltitudeAI to Combate Claim Denials with AI-Powered Automation

What You Should Know: -  Waystar (Nasdaq: WAY), a provider of leading healthcare payment software, today announced the launch of Waystar AltitudeAI™, a comprehensive set of AI capabilities for providers, including AltitudeCreate™, a new generative AI innovation focused on appealing denied claims. -  By autonomously generating appeal letters, Waystar aims to help providers recover a substantial portion of payments tied to more than 450 million annually denied claims, ultimately enabling
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Q/A: Cedar Exec Talks The Untapped Potential of AI in Healthcare Call Centers in 2025

by Fred Pennic 01/08/2025 Leave a Comment

Cedar Exec Talks The Untapped Potential of AI in Healthcare Call Centers in 2025

What if AI could dramatically reduce call volume, improve patient satisfaction, and empower your call center staff?  In this exclusive interview, Dugan Winkie, Head of Commercial Strategy at Cedar, sheds light on the often-overlooked opportunity of leveraging AI in healthcare call centers. Winkie explores the unique challenges and opportunities AI presents for providers, highlighting the potential for increased efficiency, improved patient experiences, and significant financial gains. He
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The RCM Arms Race: How AI is Reshaping Healthcare Finance in 2025

by Spencer Allee, Chief AI Officer at Aspirion 01/07/2025 Leave a Comment

The RCM Arms Race: How AI is Reshaping Healthcare Finance in 2025

As healthcare providers head into 2025, a technological arms race is reshaping revenue cycle management (RCM), with artificial intelligence (AI) emerging as the decisive factor between financial success and struggle. With approximately 46% of hospitals and health systems already utilizing AI in their RCM operations, the industry stands at a critical juncture where matching payer sophistication has become imperative for survival. This transformation represents a fundamental shift in how
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Why the CFPB Medical Debt Credit Reporting Ban Could Hurt More Than It Helps

by Karie Bostwick, VP of People and Compliance, Revenue Enterprises 01/03/2025 Leave a Comment

Why the CFPB Medical Debt Credit Reporting Ban Could Hurt More Than It Helps

The Consumer Financial Protection Bureau (CFPB) has announced that it wants to ban the inclusion of medical debt data in credit reports to lessen the negative impact of medical debt on credit scores and improve financial outcomes for consumers.  Though well-intentioned, the CFPB's medical debt credit reporting ban would severely inhibit the activities of medical collection companies who partner with healthcare providers to collect outstanding medical accounts.  It also could have
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KLAS Revenue Cycle Management Summit 2024: Top Challenges and Solutions

by Fred Pennic 12/20/2024 Leave a Comment

KLAS Revenue Cycle Management Summit 2024: Top Challenges and Solutions

What You Should Know:  - The KLAS Revenue Cycle Management Summit 2024 brought together 117 revenue cycle management (RCM) leaders to address pressing challenges, explore emerging technologies, and enhance cybersecurity in healthcare.  The KLAS Revenue Cycle Management Summit provided healthcare leaders navigating the evolving RCM landscape with practical solutions and best practices for optimizing revenue cycle operations. Top RCM Challenges and Solutions Summit attendees
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CentralReach Launches 2 AI Solutions to Maximize Clean Claims

by Jasmine Pennic 12/20/2024 Leave a Comment

CentralReach Launches 2 AI Solutions to Maximize Clean Claims

What You Should Know:  - CentralReach, a provider of Autism and IDD care software, is transforming revenue cycle management (RCM) with the launch of two innovative AI-powered solutions: CR ClaimCheckAI™ and the upcoming CR ClaimAgentAI™.  - The AI tools address critical challenges faced by ABA and multidisciplinary organizations, such as increasing profitability and optimizing cash flow, despite staffing shortages and financial constraints. CR ClaimCheckAI: Intelligent Claims
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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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