New & Notable
Amid staffing shortages, AI becomes medical coding's backup hire
Even competitive providers like UC Davis Health now use AI to support thinning medical coding teams, creating more tech-driven workflows and a fundamental shift in the workforce.
Revenue cycle AI, IDR disputes drive 9% medical cost trend
The medical cost trend is reaching its highest level in nearly two decades as AI-enabled coding and provider wins under the IDR process inflate costs, PwC says.
Reports say Ensemble is close to a $12B private equity bid
New reports say the firm founded by executive Matt Holt is close to a $12 billion acquisition of Ensemble Health Partners, marking another landmark deal in the RCM sector.
Patient access has a revenue leakage issue. Can AI solve it?
A new report finds that a typical health system loses $6.2M in avoidable referral leakage, but AI-enabled patient access centers are recapturing lost revenue.
Eli Lilly issues data sharing ultimatum to 340B hospitals
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Healthcare
Huron
Change is constant in healthcare, and its speed is accelerating. Huron works with healthcare organizations every day to strengthen and innovate their businesses and build more resilient operations to thrive now and in the future.
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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Revenue cycle AI, IDR disputes drive 9% medical cost trend
The medical cost trend is reaching its highest level in nearly two decades as AI-enabled coding and provider wins under the IDR process inflate costs, PwC says.
-
Reports say Ensemble is close to a $12B private equity bid
New reports say the firm founded by executive Matt Holt is close to a $12 billion acquisition of Ensemble Health Partners, marking another landmark deal in the RCM sector.
-
Patient access has a revenue leakage issue. Can AI solve it?
A new report finds that a typical health system loses $6.2M in avoidable referral leakage, but AI-enabled patient access centers are recapturing lost revenue.
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FinThrive bets AI can prevent denials with new product
A new product from FinThrive uses AI to get ahead of claim denials, using data from real-world payer behavior as the company undergoes another financial restructuring.
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Athenahealth unveils over 80 revenue cycle AI features
The company announced its revenue cycle management roadmap, including new AI capabilities in its flagship platform for prior authorizations, coding and denial resolution.
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No Surprises Act IDR gets major overhaul from CMS
A new final rule slashes IDR fees to $15, speeds up eligibility checks to 5 days, expands claim batching and boosts transparency to fix No Surprises Act bottlenecks.
Features
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Amid staffing shortages, AI becomes medical coding's backup hire
Even competitive providers like UC Davis Health now use AI to support thinning medical coding teams, creating more tech-driven workflows and a fundamental shift in the workforce.
-
New No Surprises Act rules won't fix $51M crisis, TX group says
Radiology Associates of North Texas expects to pay millions to participate in the No Surprises Act's IDR process even as CMS tries to alleviate major pain points for providers.
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The U.S. finally bent the healthcare cost curve, one economist says
Health economist David Cutler's new analysis shows a deceleration in U.S. healthcare spending as technology advancements make care cheaper.
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How AI scribes are shifting coding intensity, reimbursement
The proliferation of AI scribes for clinical documentation has started a shift in coding intensity, raising concerns about reimbursement and affordability.