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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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Adonis and Instacart Partner to Streamline Billing for Nutrition Programs
What You Should Know:
- Adonis, a prominent revenue cycle technology partner, announced a strategic partnership with Instacart, North America's leading grocery technology company.
- The partnership addresses a crucial aspect of expanding access to healthy foods: efficient billing for nutrition support programs. Instacart Health offers various nutrition-focused initiatives to health plan members, and with this collaboration, Instacart will leverage Adonis's advanced revenue
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Knack RCM Acquires PPM Partners, Expanding Expertise in Anesthesia RCM
What You Should Know:
- Knack RCM, a provider of tech-enabled revenue cycle management (RCM) services announced the acquisition of PPM Partners, a RCM provider specializing in the anesthesia sector. Financial details of the acquisition were not disclosed.
- The strategic move strengthens Knack RCM's position as a premier partner for anesthesia practices nationwide and expands its comprehensive suite of RCM solutions.
PPM Partners Background
Founded in 1991 and based in
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Report: AI and Automation to Reshape Revenue Cycle Management
What You Should Know:
- A new report from Everest Group, supported by Omega Healthcare, highlights the transformative impact of artificial intelligence (AI) and automation on revenue cycle management (RCM) in healthcare.
- The study, titled "Realizing the Promise of Tech-Enabled, AI-Driven Revenue Cycle Management (RCM): Outsourcing in the New Era," reveals that 85% of senior healthcare executives believe AI will significantly improve RCM efficiency in the next five
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Tackling Healthcare Claims with AI and Agentic Workflows
Last-generation technology and practices in healthcare’s claims value chain often lead to unnecessary work, provider and member friction and increased costs. Other industries deliver intelligent, largely digital billing and payment processes to consumers. It’s past time for healthcare to match or even exceed those experiences.
The challenge is that claims are complicated. Payers often have multiple contracts with different rules for the same provider group operating from multiple locations.
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Capital Rx Launches Unified Claims Processing Platform, Judi Health
What You Should Know:
- Capital Rx, a healthcare technology company announced the launch of Judi Health™, a groundbreaking unified claims processing platform.
- Judi Health is the first platform capable of administering both pharmacy and medical claims on a single system, addressing the long-standing challenges of fragmented healthcare administration and paving the way for a more efficient and patient-centric approach to care.
Streamlines Operations, Reduces Costs, and
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Candid Health Raises $52.5M for Autonomous Revenue Cycle Automation Platform
What You Should Know:
- Candid Health, a provider of autonomous revenue cycle automation solutions for healthcare providers raises $52.5M in a Series C funding round led by Oak HC/FT.
- The latest investment brings the company's total funding to $99.5M and plans to expand its customer relationships with multi-site provider groups across the United States.
AI-Powered Platform Reduces Administrative Costs and Improves Efficiency
Revenue cycle management (RCM) is a
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Human-Generated Data: The Missing Link in AI-Powered Revenue Cycles
Mounting financial pressures for healthcare organizations mean sustainability hinges on reducing the cost to collect. Ongoing challenges associated with declining reimbursements, higher clinical and administrative costs and staffing shortages in the billing department leave providers without a lot of recourse for improving operational margin. Yet within the growing list of negative bottom-line issues, there is one area where healthcare leaders have some control to improve the outlook: increasing
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KODE Health Raises $27M for On-Demand Medical Coding Platform
What You Should Know:
- KODE Health, a leading provider of on-demand medical coding solutions, today announced a $27M in Series B funding round led by Noro-Moseley Partners with participation from Mercury, FCA Venture Partners, Epsilon Innovation Fund, and 111 West Capital.
- The funding will fuel the company's mission to transform medical coding through its innovative platform that connects healthcare systems with certified coding professionals and leverages AI to optimize
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Streamlining VA Claims Processing: Guide for Healthcare Providers
Healthcare providers navigating Veterans Administration (VA) claims face complex eligibility requirements, multiple payer systems, and stringent documentation demands. These challenges create significant operational burdens for facilities and can impact veterans' access to timely care. With VA claims representing less than 5% of most hospitals' patient revenue, providers often struggle to allocate sufficient resources to master these intricate processes, leading to delayed reimbursements,
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