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

If You Are Not Using AI for Medical Coding, You Are Not Doing Your Job

by Amit Jayakar, VP of Commercial Development, Fathom 12/09/2022 Leave a Comment

If You Are Not Using AI for Medical Coding, You Are Not Doing Your Job

A quick, efficient, and well-managed revenue cycle creates a solid foundation for a profitable medical organization. That’s why if you’re responsible for ensuring the health of your organization's revenue cycle and you are not using AI for medical coding, you are not doing your job.  Let me explain. Some RCM professionals may see medical coding as a small portion of the revenue cycle; however, its reach is wide. The quality and accuracy of medical coding can either negatively or
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7 out of 10 Healthcare Workers Find it Stressful to Manage Their Finances

by Syed Hamza Sohail 12/06/2022 Leave a Comment

7 out of 10 Healthcare Workers Find it Stressful to Manage Their Finances

What You Should Know: - More than half of all healthcare workers (52%) feel less confident about their personal financial situation now compared to a year ago, according to a recent Harris Poll, among over 2,000 U.S. adults of which nearly 200 are healthcare workers, commissioned by IntelyCare and DailyPay. - The latest IntelyCare Research Group report, looks at how financial precarity and stress affect healthcare workers and simultaneously explores measures
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PayZen Nabs $200M for Personalized, No-Cost Patient Financing

by Fred Pennic 11/23/2022 Leave a Comment

PayZen Integrates with Epic’s App Orchard Marketplace

What You Should Know: - PayZen, the fintech company tackling healthcare affordability with personalized, no-cost patient financing solutions raises a $220 million growth round. The round is composed of $20 million in equity financing and a $200 million credit facility led by 7wireVentures, while Viola Credit provided a $200 million warehouse credit facility to support continued market expansion. - PayZen will use the funds to scale its operations and product development as the interest in
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Prior Authorization Reforms Don’t Address the Real Problem. Here’s How AI Can Help.

by Matthew Plack, VP for Innovation and New Solution Strategy, Apixio 11/21/2022 Leave a Comment

Prior Authorization Reforms Don’t Address the Real Problem. Here’s How AI Can Help.

After waiting weeks for an open appointment, John finally gets in to see the orthopedic surgeon to evaluate his acute knee pain. He’s already been off work for over two months and has barely been able to leave the house, popping anti-inflammatory and pain medicine to manage the pain every day.  Suspecting a torn meniscus, the doctor orders an MRI to verify the diagnosis and plan his treatment approach. The nurse begins the process by calling John’s insurance carrier to verify coverage,
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Edifecs Partners with Empowered-Home to Deliver Automated Prior Authorizations

by Fred Pennic 11/16/2022 Leave a Comment

Edifecs Partners with Empowered-Home to Deliver Automated Prior Authorization Solution to Seniors

What You Should Know: - Edifecs and Empowered-Home announced a partnership to provide automated prior authorizations to medical associations, Accountable Care Organizations (ACOs), Independent Physician Associations (IPAs), medical groups, and home health care agencies. - The Edifecs prior authorization solution combined with the clinical decision support system of patient management software company, Privis Health, forms the backbone of Empowered-Home’s ecosystem. Empowered-Home is
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Why Data Transparency Is the Most Important Metric for Healthcare Providers Right Now

by Tom Cavanaugh, VP of Product Management at Zotec Partners 11/10/2022 Leave a Comment

Why Data Transparency Is the Most Important Metric for Healthcare Providers Right Now

Healthcare providers all over the world are battling with how to take patient information and patient care digital. How can we use the tools and technology at our fingertips to make treating patients easier and more effective, rather than more complicated? Converting data into useful information will be the key to making this transition successful.  Data is the currency, language, form, and function of digital transformation in healthcare. Having an easily accessible data warehouse and
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Zelis Acquires Healthcare Payment Reimbursement Solutions Payspan

by Fred Pennic 11/10/2022 Leave a Comment

Zelis Acquires Healthcare Payment Reimbursement Solutions Payspan

What You Should Know: - Zelis, a company modernizing the business of healthcare, announced today the completion of its acquisition of Payspan, a leader in healthcare electronic payment and reimbursement automation services. Financial terms of the transaction were not disclosed. - The acquisition will accelerate Zelis' mission to modernize the business of healthcare through a connected platform and expansion of offerings for healthcare insurers, providers, and their members. Improving
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Fathom Secures $46M for AI Medical Coding Automation Platform

by Fred Pennic 11/09/2022 Leave a Comment

Fathom Receives Strategic Investment for Medical Coding Automation Platform

What You Should Know: - Fathom, an AI-powered medical coding automation platform raises $46M in Series B funding co-led by Alkeon Capital and Lightspeed Venture Partners with participation from Vituity’s Inflect Health, Cedars-Sinai, ApolloMD, Jonathan Bush, and other healthcare executives. - The company plans to use the funding to advance the standard in automated medical coding in response to critical challenges facing providers. The Series B round brings Fathom’s total funding to
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Debunking 3 Common Myths About Healthcare Revenue Cycle Partnerships

by Gary Long, EVP & CCO at R1 RCM 11/04/2022 Leave a Comment

The healthcare industry is facing unprecedented challenges, including severe labor shortages. According to a recent study, more than nine in 10 health systems and physician groups are experiencing a workforce shortage in revenue cycle management (RCM), with many of those reporting vacancies in over half of their RCM roles. This is one of the many reasons why there has never been a better time for health systems to think outside the box for solutions, including an RCM partnership. Often, when
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Cedar Launches Payer Intelligence Layer to Integrate Payer-Provider Data

by Syed Hamza Sohail 11/01/2022 Leave a Comment

Cedar Launches Payer Intelligence Layer to Integrate Payer-Provider Data

What You Should Know: - To address the systemic challenges consumers face when paying for healthcare, Cedar, an enterprise healthcare engagement platform that improves the end-to-end consumer financial journey, has developed the Payer Intelligence Layer. - With the Payer Intelligence Layer, Cedar can now integrate data from health insurers and healthcare providers to help create a single source of information for consumers managing medical bills. A game-changer for the healthcare industry,
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