What You Should Know:
- Lyric, a recognized leader in solutions for healthcare payment accuracy and integrity, has officially announced its acquisition of ClaimShark. ClaimShark is known for its innovative technology platform designed to enhance integration, transparency, and precision in payment integrity for health plans.
- The strategic move will see ClaimShark's solutions integrated into the Lyric 42 Platform, Lyric's flagship AI-driven offering, significantly advancing Lyric's
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
John Snow Labs Unveils New AI-Powered HCC Coding Engine
What You Should Know:
- John Snow Labs, a company specializing in artificial intelligence for healthcare, today announced the launch of its new, end-to-end Hierarchical Condition Category (HCC) coding engine.
- Introduced during the company’s annual Healthcare NLP Summit, this solution is engineered to assist healthcare providers and payers in significantly improving risk adjustment accuracy and strengthening revenue integrity.
Addressing Critical Gaps in Risk
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Youlify Raises $4.3M to Optimize Medical Billing with Generative AI
What You Should Know:
- Youlify, a physician-founded AI company rebuilding the financial backbone of healthcare, today announced $4.3 million in seed funding to help hospitals and doctors get paid faster and more accurately.
- The platform replaces traditional billers with AI and provides an end-to-end revenue cycle management platform that completely automates coding, claims, and denial recovery. The round was led by Brett Queener at Bonfire Ventures, with participation from Top Harvest
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Protecting Margins in Home-Based Care with Smarter Revenue Cycle Management
Healthcare providers are heading into another year where financial uncertainty remains a top concern. While many for-profit and nonprofit organizations reported improved margins in 2024, industry analysts warn that rising expenses and process inefficiencies could put those gains at risk. Home-based care agencies, in particular, continue to face workforce shortages, changing reimbursement structures and administrative challenges – making revenue cycle management (RCM) a critical tool for
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RISA Labs Raises $3.5M for AI-Powered Oncology Prior Authorizations Platform
What You Should Know:
- Cancer patients don’t just fight the disease - they fight the system. Today, life-saving treatments are routinely delayed by days or even weeks due to manual, error-prone workflows
- To solve this, RISA Labs has raised a $3.5M funding round to help healthcare organizations eliminate one of the most persistent barriers to timely cancer care: prior authorization delays. RISA Labs has already proven that faster care is possible by dramatically reducing manual
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Thoughtful.ai Secures Strategic Investment to Advance AI-Powered Revenue Cycle Automation
What You Should Know:
- Thoughtful.ai, a company specializing in artificial intelligence (AI)-powered revenue cycle automation has received a strategic investment from New Mountain Capital, a growth-oriented investment firm with over $55B in assets under management.
The investment aims to support Thoughtful.ai’s continued growth and accelerate the adoption of automation and AI solutions to address the complex challenges faced by healthcare
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CareCloud Acquires RevNu Medical Management to Expand Audiology RCM
What You Should Know:
- CareCloud, a provider of practice management, healthcare technology, and AI-driven solutions for medical practices acquires RevNu Medical Management (RevNu), an emerging revenue cycle management (RCM) company specializing in audiology.
- Financial details of the acquisition were not disclosed.
Expanding in the Audiology Market
This acquisition represents a strategic move by CareCloud to expand its presence in the U.S. audiology market. The U.S.
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With RCM Staff in Short Supply, Is AI the Missing Piece?
A hefty 63% of healthcare providers are grappling with revenue cycle management (RCM) staffing shortages, causing significant operational and patient-care challenges across the healthcare system.
The staffing deficit has created a challenging cycle: understaffed RCM departments struggle to handle claims denials, leading to delayed reimbursements and increased administrative costs. When staff members spend excessive time investigating and correcting denied claims, it prevents them from
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Layer Health Raises $21M for AI-Powered Medical Chart Review
What You Should Know:
- Layer Health, a health technology company leveraging advanced AI to transform chart review, raises $21M in Series A funding round led by Define Ventures with participation from other prominent investors.
- The funding will enable Layer Health to scale its AI-powered platform, expand its team, and further its mission to improve healthcare efficiency, reduce costs, and enhance patient outcomes.
AI to Tackle Healthcare's Data Challenge
Founded by veteran AI
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How to Balance AI and Human Expertise in the Middle Revenue Cycle
While artificial intelligence (AI) can automate many functions within the middle revenue cycle, there remains a need for human expertise to manage complex, nuanced decisions to ensure high accuracy and proper context. Ultimately, AI should complement – not replace – humans to drive greater efficiency without compromising quality.
In revenue cycle management (RCM), the middle cycle refers to the phase between the front end, which is patient access and care delivery, and the back end,
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