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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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
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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Beyond Chargemaster Rates: Rethinking Revenue Generation in Healthcare
In the ever-evolving landscape of healthcare, one constant remains: the need for financial stability and growth. Healthcare providers, facing rising operational costs, regulatory changes and increased competition, must evolve their financial strategies to ensure long-term sustainability.
Historically, healthcare providers have relied heavily on chargemaster rates—the set list prices for medical services—as a primary method for revenue generation. However, as the industry faces increasing
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HCA Healthcare UK Deploys Hyland’s AI-Driven AP Solutions
What You Should Know:
- Hyland, a leading provider of content management solutions, today announced a strategic partnership with HCA Healthcare UK to optimize financial operations and enhance data accessibility through its AI-driven Accounts Payable (AP) solutions.
- The collaboration leverages several cornerstone products of Hyland's unified Content Innovation Cloud, empowering HCA Healthcare UK to streamline processes, reduce costs, and drive scalability for future
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The Future of Revenue Cycle Management (RCM) in Healthcare: 4 Key Trends to Watch in 2025
The revenue cycle management (RCM) landscape for healthcare is poised for significant transformation over the next few years. As the industry continues to evolve, RCM providers and their customers face a complex web of challenges and opportunities. Among the key trends shaping RCM in 2025 are:
Rising Costs Driven by Cybersecurity and Regulatory Compliance Demands and Increasing Patient Bad Debt Rates The cost of doing business is increasing. RCM providers invest in robust
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