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

Protecting Margins in Home-Based Care with Smarter Revenue Cycle Management

by Meghan May, Senior Manager of Client Success, TES, at Homecare Homebase 04/17/2025 Leave a Comment

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

by Syed Hamza Sohail 04/17/2025 Leave a Comment

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

by Fred Pennic 04/11/2025 Leave a Comment

Thoughtful AI Secures $20M, Launches Human-Capable RCM AI Agents

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

by Fred Pennic 04/02/2025 Leave a Comment

CareCloud

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?

by Spencer Allee, Chief AI Officer at Aspirion 03/31/2025 Leave a Comment

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

by Fred Pennic 03/27/2025 Leave a Comment

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

by Jennifer Weinberg, MD, Physician Advisor and Vice President of Operations, R1 03/21/2025 Leave a Comment

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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Adonis and Instacart Partner to Streamline Billing for Nutrition Programs

by Jasmine Pennic 03/18/2025 Leave a Comment

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

by Fred Pennic 03/11/2025 Leave a Comment

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

by Fred Pennic 03/05/2025 Leave a Comment

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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