What You Should Know:
- Humata Health, a provider of AI-powered prior authorization technology, has been selected by the Centers for Medicare & Medicaid Services (CMS) as a key partner for its new initiative: the Wasteful and Inappropriate Service Reduction (WISeR) model.
- CMS, the single largest payer for healthcare in the U.S., has chosen Humata Health to deploy its proprietary technology in a program that directly addresses the staggering variability of care and significant
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Demystifying Prepay Coordination of Benefits: A Crucial Component of Payment Integrity
Coordination of benefits (COB) is a key component of any effective payment integrity program. But determining primacy for members with multiple plans and ensuring claims aren’t overpaid can be a complicated process. Whether it’s verifying employment status or sifting through complicated claims, COB takes significant time for peak accuracy. And while health plans focus on the intricacies of an effective COB strategy, many overlook the possibilities that a comprehensive prepay COB solution can
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Datavant and athenahealth Partner to Automate Medical Record Release at Scale
What You Should Know:
- Datavant, a data collaboration platform, and athenahealth, Inc., a provider of network-enabled software and services announced an anticipated partnership aimed at transforming the historically manual and fragmented process of medical record requests and releases.
- By bringing together athenahealth’s market-leading EHR platform with Datavant’s expertise in health data exchange, the companies plan to build a modern, comprehensive infrastructure for data
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The $168B Answer: How AI Can Tame Healthcare’s Untamed Administrative Beast
A quick google (or generative AI) search will pour hundreds of statistics about the dire state of healthcare costs plaguing our nation. Whether it’s the fact that we spend almost 5x as much as neighboring Canada per capita on healthcare administrative costs or that it means every 4th dollar spent is wasted, there are numerous scary statistics we have grown used to reading.
It certainly wasn’t meant to be.
How did a system designed to heal become so broken and smeared in complexity
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Microsoft Unveils Expanded Dragon Copilot: AI Transformation for Nursing and Revenue Cycle
What You Should Know:
- Microsoft unveiled significant AI innovations for its leading clinical assistant, Dragon Copilot, leveraging ambient and generative technologies to enhance the patient journey, reduce workflow burden, and strengthen the financial integrity of healthcare provider organizations.
- The advancements include the industry’s first generally available commercial ambient experience tailored for nursing workflows and new extensibility capabilities that allow
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R1 to Acquire Phare Health: Unifying AI-Native Coding and Clinical Documentation Improvement
What You Should Know:
- R1, a provider of healthcare revenue management automation, today announced an agreement to acquire Phare Health, a technology company specializing in AI-native solutions for inpatient coding and clinical documentation improvement (CDI).
- The acquisition is a significant step in R1’s strategy to comprehensively automate the revenue cycle and move closer to real-time adjudication of medical claims.
Unifying Clinical Documentation and Financial
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Cleveland Clinic Deploys GenAI for Coding and CDI Across Enterprise Powered by AKASA
What You Should Know:
- Cleveland Clinic, one of the top academic medical centers in the U.S., has significantly expanded its partnership with AKASA, a leader in healthcare AI, to deploy an advanced Clinical Documentation Integrity (CDI) solution across all of its U.S. locations.
- The enterprise deployment follows a successful pilot and the system-wide adoption of AKASA’s AI coding tool, solidifying Cleveland Clinic’s position as a pioneer in applying generative AI (GenAI) to
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AGS Health Unveils Agentic AI Solutions to Combat Rising Claim Denials and Margin Pressure
What You Should Know:
- AGS Health®, a strategic growth partner and leading provider of tech-enabled RCM solutions, today announced the introduction of a new suite of agentic digital workforce solutions.
- Powered by AI agents and intelligent automation, these solutions are designed to help healthcare providers navigate the unprecedented strain caused by rising claim denials, severe staffing shortages, and mounting financial pressures.
Market Pressures Driving Urgent Change
The
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Infinx Invests in Voxology AI: Voice-First Automation Transforms Patient Access and Revenue
What You Should Know:
- Infinx, a prominent provider of AI-powered solutions for patient access and revenue cycle management (RCM), announced a strategic investment in Voxology AI, a healthcare technology company specializing in conversational AI agents for the front office.
- The partnership integrates voice-first automation directly into Infinx’s contact center solutions, creating a unified platform that manages both patient-facing front-office workflows and back-office
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Why RCM Performance Hinges on Supporting and Empowering Your Workforce
We talk a lot about improving revenue cycle performance: better workflows, fewer denials, faster reimbursement. And most of the time, the default solution is a new technology, a better process, or another vendor.
As someone who’s spent my career in revenue cycle, and is passionate about building tech that addresses its unique challenges, I can tell you this:
Even the smartest systems won’t fix a workforce that’s disengaged, under-supported, or misaligned.
Great technology is
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