Nine out of 10 healthcare leaders expect disruptive pressures to increase tremendously in the year ahead, according to a recent survey. However, fewer than half believe their organizations are prepared to withstand these forces.
In an era of transformation—in which traditional business models are continually being revamped in response to pressures such as consumerism, policy changes, and the market entrance of non-traditional healthcare players such as Amazon and Apple—payers face daunting
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Cedar Unveils New Insurance Features for Patient Payment Platform
Cedar has announced the expansion of its patient payment and engagement solution, Cedar Pay, with innovative features designed to guide patients to the best resolution for common insurance-related issues.Patients are half as likely to pay claims with unexpected insurance adjustments (such as common denials) than they are for standard adjustments (such as a deductible), as identified by Cedar data. The gap is driven by the failure of most billing communications to proactively give patients the
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Revenue Leakage: 3 Methods to Revive Your Charge Integrity Program
Many consider a strong charge integrity program the cornerstone and heartbeat of the revenue cycle. Without an effective charge integrity program, health care providers run the risk of revenue leakage.
According to the Healthcare Financial Management Association, “one percent of net patient revenue is lost due to charge capture errors,” which can add up to multi-millions of dollars for health care organizations. Most providers have not considered or quantified the potential dollars lost when
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Change Healthcare: Applying AI Could Identify Up to 35% of Denials Prior to Submission
Change Healthcare AI can help providers identify problem claims and prevent denials before they happen, avoiding costly rework, delays, and improving revenue flow.Today Change Healthcare announced that it has applied its Claims Lifecycle Artificial Intelligence (AI) technology to its claims management suite with the introduction of Assurance Reimbursement Management™ Denial Propensity Scoring and Revenue Performance Advisor Denial Prevention. With performance enhanced by Claims Lifecycle AI,
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Olive, Clinc Partner to Add Conversational AI to Digital Healthcare Employee for Hospitals
Olive, the company that introduced healthcare’s AI-driven digital employee has joined forces with Clinc, another trailblazer in Artificial Intelligence (AI), to free up time and resources by adding conversational AI capabilities to its existing technology. The combined offering allows Olive’s digital healthcare employee to bring hospitals and health systems broader applications across revenue cycle, supply chain and other financial and operational departments.
While new technologies
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UnitedHealth to Acquire Payment Integrity Company Equian for $3.2B
UnitedHealth Group Inc. has agreed to acquire payment integrity provider Equian from its private-equity owner New Mountain Capital for about $3.2 billion, according to the Wall Street Journal report on Thursday evening.Equian delivers payment integrity solutions through proprietary content, enabling technology, and highly responsive customer service. The company analyzes over $500B in healthcare and insurance data to ensure payments are fair, accurate, and paid by the correct party—resulting in
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Surescripts Inks Partnerships with National Health Plans to Streamline Prior Authorization
Surescripts announced that several national, regional and local PBMs and health plans representing virtually all U.S. patients are replacing their manual prior authorization process with Surescripts Electronic Prior Authorization solution. Over the past 18 months, several national, regional and local PBMs and health plans representing virtually all U.S. patients have signed on, increasing the number of insured lives covered by Surescripts Electronic Prior Authorization by nearly 20%.Impact of
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CredSimple Raises $14M to Redefine The Provider Credentialing Process
CredSimple, the a NYC-based cloud-based healthcare credential verification organization, has raised $14 million in Series B funding led by Questa Capital. The round also included participation from existing investors including Windham Venture Partners who led the company's Series A round and Primary Ventures who co-led its seed investment.Outdated Credentialing ProcessTraditionally, credentialing has run on outdated systems, spreadsheets, and repetitive manual work that only increases work,
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R1 RCM, Intermountain Opens Technology and Innovation Center
On Tuesday, R1 RCM announced the grand opening of its new Salt Lake City Technology and Innovation Center in collaboration with Intermountain Healthcare. This state-of-the-art facility will be the first of its kind to test and develop new technology to redefine the healthcare revenue cycle process and the patient financial experienceThe grand opening event brought together R1 and Intermountain Healthcare leaders, community business leaders, and local nonprofit organizations for a ribbon cutting,
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Revenue Cycle Startup Nym Lands $6M for Autonomous Medical Coding Solution
Nym, an Israeli-based autonomous medical coding technology provider announced that it has secured a $6 million seed funding, led by Bessemer Venture Partners. Founded in 2018 by Amihai Neiderman and Adam Rimon, Nym’s automatic medical language understanding technology streamlines the hospital revenue cycle.Traditional Cumbersome Medical Coding ProcessThere are over 250,000 medical coders in the United States today manually reviewing patient charts and assigning the applicable medical codes
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