What You Should Know:
- CentralReach, a provider of Autism and IDD care software, is transforming revenue cycle management (RCM) with the launch of two innovative AI-powered solutions: CR ClaimCheckAI™ and the upcoming CR ClaimAgentAI™.
- The AI tools address critical challenges faced by ABA and multidisciplinary organizations, such as increasing profitability and optimizing cash flow, despite staffing shortages and financial constraints.
CR ClaimCheckAI: Intelligent Claims
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Aspirion Acquires Boost Healthcare to Enhance RCM Capabilities
What You Should Know:
- Aspirion, a provider of healthcare technology revenue cycle management (RCM) solutions, today announced the acquisition of Boost Healthcare, a revenue cycle firm that joins revenue cycle leaders on their journey to improve their organization’s financial performance. Financial details of the acquisition were not disclosed.
- The strategic acquisition strengthens Aspirion's commitment to helping healthcare providers secure accurate and timely reimbursement for
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4 Cornerstones for Successful AI Implementation in Hospital Revenue Cycle Management in 2025
In recent years, payers have increasingly turned to artificial intelligence (AI) as a tool to streamline claims processing, accelerating the deployment of rules related to prior authorizations and medical-necessity assessments. Providers believe this has been a key driver behind a corresponding surge in claims denials, as well funded payers leverage technology to rapidly render these determinations and send them back to hospitals.
This trend has providers looking to respond with a
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Cofactor AI Nabs $4M to Combat Hospital Claim Denials with AI
What You Should Know:
- Hospitals across the country are facing an ever-increasing onslaught of claims denials from insurance companies, with denials up 20.2% in 2023, according to the American Hospital Association. These denials – triggered by AI and often error-prone – cost hospitals $20 billion a year in administrative bloat and reduce patients’ access to quality care.
- To help hospitals fight back, Cofactor AI today introduced a new first-of-its-kind AI-powered
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Revitalizing Medicare Advantage: How The Push to Streamline Prior Authorization Will Impact Senior Care
As a physician, the odds that you’ve had a negative experience related to the prior authorization process are (unfortunately) highly likely. According to the American Medical Association’s (AMA) 2023 Prior Authorization Physician Survey, 1 in 4 physicians report that prior auths “have led to a serious adverse event for a patient in their care.” Think about the toll that this takes on professionals whose primary job is providing lifesaving care, and the thing preventing this care is outside their
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Tassat, Veuu Partner to Streamline Healthcare Claims and Payments with Blockchain
What You Should Know:
- Tassat Group, Inc., the leading provider of private permissioned blockchain-based real-time settlement solutions, today announced its strategic partnership with Veuu, an innovative AI-powered healthcare fintech company, to improve the inefficiencies and opaqueness plaguing the healthcare claims and payment process.
- Leveraging Tassat’s smart contract capabilities, this collaboration empowers Veuu with a solution to provide greater confidence in the traceability
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Thoughtful AI Launches AI Agents to Optimize Revenue Cycle Management
What You Should Know:
- Thoughtful AI, an innovator in AI-powered revenue cycle transformation, has announced the launch of its comprehensive team of specialized AI Agents for revenue cycle management (RCM).
- By optimizing back-office operations and reducing delays in billing, approvals, and claims processing, Thoughtful AI enhances the patient experience. This leads to faster access to care, fewer billing errors, and improved transparency regarding out-of-pocket
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HealthEdge, Codoxo Partner for GenAI-Driven Payment Integrity
What You Should Know:
- HealthEdge® and Codoxo announce a strategic partnership to provide healthcare payers with the industry’s most cutting-edge solutions and services.
- This partnership will streamline and enhance their respective end-to-end payment integrity processes by leveraging HealthEdge Source™ in conjunction with Codoxo’s GenAI-driven Unified Cost Containment Platform. By joining forces to deliver an end-to-end payment integrity solution, healthcare payers will benefit from
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Bluespine Raises $7.2M to Combat Medical Overbilling with AI
What You Should Know:
- Bluespine, an AI-driven claims cost reduction platform for self-insured employers, has secured $7.2M in seed funding to address the pervasive issue of medical overbilling in the US healthcare system led by Team8.
- The seed funding will accelerate Bluespine's adoption by US employers and brokers, as well as support further research and development.
Tackling the Healthcare Cost Crisis
Bluespine was co-founded by a team of technology experts with deep
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Payment Integrity in Healthcare: Challenges and Solutions
Whether you work in healthcare or are just a patient who has interacted with the healthcare system, it shouldn't surprise you to read that healthcare costs have been going up and are expected to continue to do so into 2025 burdening all stakeholders. Despite the obvious need to cut wasted healthcare spending, research suggests that the industry as a whole isn’t very good at it, with administrative spending being one of the biggest culprits. One study found that nearly one-third of excess U.S.
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