The U.S. healthcare system is grappling with a surge in claim denials and prior authorization requirements, creating significant challenges for both providers and patients. To shed light on this pressing issue, we spoke with Oron Afek, CEO of Vim, a company that assists over 20,000 providers and 80% of the largest U.S. payers with prior authorizations.
In this interview, Oron Afek provides valuable insights into the challenges and potential solutions related to claim denials and prior
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Hancock Health Selects revology to Manage Revenue Cycle Ops
What You Should Know:
- Revology, a provider of revenue cycle management (RCM) solutions, has announced a multi-year contract with Hancock Health to manage its RCM operations.
- Hancock Health expanded its partnership with revology after the RCM firm helped increase cash collections, resulting in an additional $10 million for the organization.
Addressing RCM Challenges in Healthcare
Healthcare organizations face growing challenges in managing their revenue cycles effectively.
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SmarterDx Launches AI-Powered Appeals Solution to Fight Payer Denials
What You Should Know:
- SmarterDx, a provider of clinical AI for revenue integrity, has announced the launch of SmarterDenials, an innovative AI-driven solution designed to help hospitals fight unjust claim denials.
- With denials on the rise, causing operational disruptions and revenue loss for healthcare providers, SmarterDenials empowers hospitals to generate stronger clinical appeal letters and secure faster and more accurate reimbursements.
Addressing the Growing
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Backed by Visa, Osigu Secures $25M to Modernize Healthcare Payments Across Latin America
What You Should Know:
- Osigu, an AI-powered platform for healthcare claims and revenue management in Latin America and the Caribbean, has raised $25 million in Series B funding led by IDC Ventures, with strategic participation from Visa.
- Visa's strategic investment and partnership will drive the development of real-time payment solutions for healthcare providers.
Addressing Healthcare Payment Inefficiencies
The healthcare sector in Latin America and the Caribbean faces
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FinThrive Integrates with Oracle Health Patient Accounting for Claim Management
What You Should Know:
- Enhanced Claims Management: FinThrive and Oracle Health have completed a collaborative development effort, now certified, that seamlessly integrates FinThrive’s claims management solution with Oracle Health Patient Accounting, enhancing claims processing for Oracle Health customers.
- Streamlined API Integration: This integration utilizes API technology to deliver a unified login experience and improve real-time claim edits, enabling Oracle Health users to
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HLTH: Blue Shield of California, Salesforce Partner on Real-Time AI Prior Authorizations
What You Should Know:
- Blue Shield of California and Salesforce are joining forces to tackle a major pain point in healthcare: the lengthy and often frustrating process of prior authorizations.
- The new AI-powered platform solution, built on Salesforce Health Cloud, aims to deliver near real-time prior authorization decisions, streamlining healthcare delivery and improving patient experience.
Addressing the Burden of Prior Authorizations
Prior authorizations are a
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The Fine Print of Health Insurance: Why Surprise Bills Are So Common?
Surprise medical bills can be a major headache for anyone, but they can be annoyingly common for those with high-deductible health insurance plans (HDHPs). In fact, half of patients with an HDHP state they have received a surprise medical bill, even though they have insurance coverage.
High-deductible plans typically feature lower monthly premiums but higher out-of-pocket expenses. However, these plans can leave patients on the hook for unexpected medical costs that they may not be able to
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Tanner Health Partners with Corti to Revolutionize Medical Coding with AI
What You Should Know:
- In a move set to transform healthcare operations across Georgia and Alabama, Tanner Health and Healthliant Ventures have announced a strategic partnership with Corti, the trusted AI platform to healthcare systems worldwide.
- The collaboration is expected to significantly streamline medical coding, reduce administrative burdens by 80 percent, and enhance the overall accuracy of billing systems. This integration will empower healthcare professionals to spend less
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XiFin RPM Achieves HITRUST r2 Certification for Enhanced Information Security
What You Should Know:
- XiFin, Inc., a healthcare information technology solutions provider, has announced that its revenue cycle management (RCM) solution, XiFin RPM, has once again earned the HITRUST r2 Certification.
- The HITRUST r2 Certification is widely recognized as the most rigorous standard for information security in the healthcare industry. It validates that XiFin RPM meets stringent requirements for safeguarding sensitive patient data and maintaining compliance with
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Transforming Insurance Verification and Authorizations with AI
Across many healthcare organizations, front-office staff face a significant dilemma: patients seeking help only to be told that their health insurance verification and authorization process could take several days or even months. According to a study by the AMA, more than nine in ten physicians recently surveyed said that prior authorization negatively impacts patient clinical outcomes and, often, leads to treatment abandonment.
This issue mainly arises because current, manual insurance
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