What You Should Know:
Tower Health and Ensemble Health Partners (Ensemble), the market leader in end-to-end revenue cycle outsourcing for mid-sized to large healthcare organizations, announced today that they will enter into a strategic partnership for the management of all revenue cycle operations.This partnership will allow Tower Health’s hospitals and physician practices to focus on delivering exceptional care in their communities while Ensemble manages day-to-day revenue cycle
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Physician Practices Struggle After Change Healthcare Cyberattack: Unpaid Claims, Staff Strain, and Potential Closures
What You Should Know:
- A recent American Medical Association (AMA) survey reveals the ongoing crippling effects of the Change Healthcare cyberattack on physician practices across the United States.
- The survey was conducted after UnitedHealth Group (UHG) said that claims would be flowing by the weekend of March 23. Despite UHG’s assurances, the attack, which began in February 2024, has disrupted claim processing and caused significant financial strain, jeopardizing patient
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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
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
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
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
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%
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
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
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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