- UPMC, a Pittsburgh-based healthcare provider and insurer, announced it is expanding its strategic partnership with Kyruus to further optimize patient access. - UPMC has been a Kyruus customer since 2019 and now will be directly investing in the company and collaborating on the future development of Kyruus’ ProviderMatch platform. Last year, UPMC expanded its relationship with Kyruus to enable consumers to find care and book appointments — directly into the health system’s electronic
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Cedar Launches Cedar Pre to Transform Patient Financial Experience
What You Should Know: - Cedar launches Cedar Pre to deliver seamless and comprehensive healthcare experiences to consumers preparing for care. - By leveraging Cedar’s expanded patient engagement suite, providers can empower patients with unprecedented access and affordability from pre-registration and intake through final payment. Cedar, a New York City-based healthcare financial technology platform built for today’s consumers, today announced the launch of Cedar Pre, an
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Lynx Launches with $17.5M for API-Connected Healthcare Payments
What You Should Know: - Lynx, a Boston-based API-connected healthcare payments, banking, and e-commerce platform announced today that it has emerged from stealth with $17.5M in equity financing led by Obvious Ventures and .406 Ventures with participation from Frist Cressey Ventures. Other investors include Winter Street Ventures (an investment subsidiary of Commonwealth Care Alliance), Shields Capital, and Huntington Avenue Ventures. - Lynx’s goal is to introduce modern fintech to
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GuideWell Becomes First U.S. Payer to Automate Prior Authorizations
What You Should Know: - GuideWell, one of the 10 largest health insurance providers in the U.S., became the first U.S. payer to automate prior authorization approvals through AI-powered clinical reviews from Olive, resulting in faster care for patients — up to 10 days faster — and greater provider satisfaction. - After launching a pilot with Olive in Florida, GuideWell saw its time to decision reduced by 10 days when immediate responses were available, decreased unnecessary prior
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5 Trends Bringing Effective Intelligence into Revenue Cycle in 2022
5 revenue cycle management trends that will drive adoption of automation, data-first processes, employee effectiveness and virtualization Many physician practices are facing a harsh reality as they enter 2022: The revenue cycle processes and technology that have traditionally produced an acceptable bottom line are no longer delivering. Tectonic shifts in the way healthcare organizations are reimbursed are unearthing the shortfalls of reactive systems that don’t get ahead of claims issues,
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Recruitment Costs, Long Hiring Timelines Negatively Impact Healthcare Finance Teams
What You Should Know: - AKASA, a developer of AI for healthcare operations, today released findings from a new survey highlighting the challenges hospitals and health systems are facing within the revenue cycle as the Great Resignation drives higher staff turnover, and skilled workers leave healthcare for higher-paying jobs in other industries like retail or logistics - Commissioned by AKASA, the survey fielded responses from 514 chief financial officers and revenue cycle leaders at
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Clamping Down on Upcoding Risk: 3 Steps to Ensure Proper Payment & Compliance
A recent report from the HHS Office of the Inspector General (OIG) turned heads across the healthcare industry after pointing to a notable rise in inpatient hospital stays where upcoding was believed to be the culprit. Compliance professionals who have been in the healthcare industry any length of time know what's next: targeted billing reviews by the Centers for Medicare and Medicaid Services (CMS) around hospital stays that are vulnerable to upcoding. More
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3 Ways Real-Time ADT Notifications Will Benefit Payers’ Businesses
Payers and providers share goals around emerging healthcare delivery models such as value-based care and accountable care organizations (ACOs). But inadequacies in current payer/provider communication often disrupt the flow of timely care and lead to unnecessary hospital readmissions and poor outcomes. What’s needed in this partnership is the standardized, fluid, real-time exchange of data to help both parties become even more efficient and effective at providing members the proper care at the
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Revenue Cycle Management Can Help Advance The Cybersecurity Mandate
Holding steady in the No. 1 spot, the healthcare industry has held the top rank in IBM’s Cost of Data Breach report for the past 11 years. It’s a lead that seems secure. In just a year from 2020-2021, the average total cost for healthcare for an event increased 29.5%, and now sits at $9.23 million. Even amidst that threat landscape, the percentage those in the healthcare space spend on cybersecurity hasn’t climbed out of the single digits. Only 6% or less of the IT budget is typically
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R1 Acquires Revenue Cycle Company Cloudmed for $4.1B
What You Should Know: - R1, a leading provider of technology-driven solutions that reduce friction in healthcare, has just acquired CloudMed, a leader in Revenue Intelligence™ for healthcare providers in a $4.1B cash deal. - Upon closing of the transaction, current R1 shareholders will own approximately 70% of the combined company on a fully diluted basis and Cloudmed equity holders will own approximately 30%. Cloudmed equity holders will enter into an 18-month lockup agreement, subject to
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