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

Availity Launches AI-Powered Claims Denial Prediction Tool

by Jasmine Pennic 04/05/2024 Leave a Comment

Availity Launches AI-Powered Claims Denial Prediction Tool

What You Should Know:  - Availity, a real-time health information network launches Predictive Editing, a revolutionary feature within its Availity Essentials Pro™ platform.  - The AI-powered tool developed in partnership with Anomaly Insights empowers healthcare providers to significantly reduce claim denials, leading to smoother revenue cycle management and improved financial performance. The Problem: Costly Claim Denials Denied claims are a major pain point for healthcare
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Talkiatry & Cedar Partner to Tackle Mental Health Payment Woes

by Jasmine Pennic 04/02/2024 Leave a Comment

Talkiatry & Cedar Partner to Tackle Mental Health Payment Woes

What You Should Know: - Talkiatry, a provider of in-network psychiatric care, has partnered with Cedar, a healthcare financial engagement platform, to optimize the billing experience for their patients. - The strategic partnership prioritizes not only mental health treatment itself, but also the financial barriers that often prevent individuals from seeking or continuing care. Mental Health Crisis Demands Solutions The United States faces a significant mental health crisis, with one
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The ‘Holy Grail’ of Coding Automation: Why Inpatient AI is Around The Corner

by Andrew Lockhart, CEO, Fathom 03/28/2024 Leave a Comment

The 'Holy Grail' of Coding Automation: Why Inpatient AI is Around The Corner

Autonomous inpatient coding. This may sound like a pipe dream for revenue cycle leaders, whose hopes were likely raised and crushed in the early aughts. But it's coming sooner than most think. Why is true inpatient coding automation the "holy grail" – as Kerry Gillespie, a former CFO at Intermountain Health and now an executive consultant at Warbird Consulting Partners, said to me at a Healthcare Financial Management Association roundtable last year? For decades, inpatient services have
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Sutter Health Partners with Abridge to Reduce Clinician Burnout with GenAI-Powered Documentation

by Fred Pennic 03/27/2024 Leave a Comment

Sutter Health Partners with Abridge to Reduce Clinician Burnout with GenAI-Powered Documentation

What You Should Know: - Sutter Health, a leading California healthcare system, announced a major collaboration with Abridge, a company specializing in generative AI for clinical documentation. - The strategic partnership aims to transform the way physicians document patient interactions, ultimately improving patient care and reducing physician burnout. Abridge: Streamlining Documentation and Freeing Up Physician Time Physicians nationwide spend a significant amount of time on
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Zelis Unveils New In-Network Pricing Solution for Streamlined Claim Processing

by Jasmine Pennic 03/26/2024 Leave a Comment

Zelis Unveils New In-Network Pricing Solution for Streamlined Claim Processing

What You Should Know: Zelis, a leader in healthcare technology solutions, has announced its newest weapon in the fight against opaque claim pricing: In-Network Pricing and Contract Modeling. This comprehensive solution empowers health plans to understand and manage claim pricing proactively, leading to more accurate cost estimates and improved financial control. A Complete Claim Pricing Suite: Precision and Transparency In-Network Pricing and Contract Modeling joins Zelis' existing
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AKASA Unveils Gen AI Assistant, Cuts Prior Authorization Time by 50%

by Fred Pennic 03/14/2024 Leave a Comment

AKASA Unveils Gen AI Assistant, Cuts Prior Authorization Time by 50%

What You Should Know: - AKASA, a leader in generative AI (GenAI) solutions for the revenue cycle, today announced the launch of Authorization Advisor™. - Authorization Advisor tackles the time-consuming and error-prone process of prior authorization, a major pain point for healthcare providers. Prior Authorization Made Easy with AI Prior authorization, a process requiring approval from insurers before delivering certain services, is a significant burden for healthcare providers. It
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Feds Launches Investigation of Change Healthcare Cybersecurity Attack

by Fred Pennic 03/13/2024 Leave a Comment

HHS Launches Investigation of Change Healthcare Cybersecurity Attack

What You Should Know: - The Department of Health and Human Services' Office for Civil Rights (OCR) has announced an investigation into the recent cyberattack on Change Healthcare, a subsidiary of UnitedHealth Group (UHG). - The cybersecurity attack has significantly disrupted healthcare billing and information systems nationwide, potentially impacting patient care. Investigation Focuses on HIPAA Compliance The OCR enforces the Health Insurance Portability and Accountability Act
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Availity Processes More Than $5B in Claims Stuck with Change Healthcare

by Fred Pennic 03/13/2024 Leave a Comment

Availity Processes More Than $5B in Claims Stuck with Change Healthcare

What You Should Know: - The Change Healthcare cybersecurity breach continues to disrupt the healthcare industry three weeks after the initial incident. Hospitals, physicians, pharmacists, and health plans are struggling to maintain operations amidst logistical and financial challenges. Patients nationwide face uncertainty regarding their ability to receive necessary care. - Availity, the nation's largest real-time health information network, has emerged as a key resource in helping these
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HIMSS24: CodaMetrix Secures $40M for AI-Driven Medical Coding Solutions

by Fred Pennic 03/12/2024 Leave a Comment

CodaMetrix Secures $40M for AI-Driven Medical Coding Solutions

What You Should Know: - CodaMetrix, a provider of artificial intelligence (AI) solutions for healthcare revenue cycle management, has announced the successful closing of its $40 million Series B funding round led by Transformation Capital with participation from existing investors SignalFire, Series A lead, and Frist Cressey Ventures. - The Series B funding round will fuel further development of CodaMetrix's AI-powered platform, designed to streamline medical coding, improve data quality,
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Frazier Healthcare Acquires RevSpring to Bolster Payment Solutions in Healthcare

by Jasmine Pennic 03/12/2024 Leave a Comment

Frazier Healthcare Acquires RevSpring to Bolster Payment Solutions in Healthcare

What You Should Know: - Frazier Healthcare Partners, a leading healthcare investment firm, announced today the successful acquisition of RevSpring. - RevSpring, a provider of end-to-end communication and payment solutions for healthcare and financial services companies, will join Frazier's portfolio. Frazier's Investment Fuels RevSpring's Future The acquisition brings together RevSpring's established presence in the communication and payment solutions market with Frazier's deep
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