Gen AI is coming for medical bills; 3 ways to prepare
Patients are behind one of the latest applications of AI to the healthcare revenue cycle, and they are using it to review their bills. Stories of consumers using ChatGPT or other generative AI tools to trim thousands from their medical bills by questioning charges are appearing in the news and social media. YahooFinance wrote about…
How to optimize the revenue cycle workforce in 2026
In 2026, revenue cycle performance is inseparable from workforce design. Health systems are navigating sustained margin pressure, rising patient cost responsibility and escalating payer complexity — all while competing for limited domestic talent. Recent Kaufman Hall National Hospital Flash Reports continue to show margin volatility across U.S. hospitals, with labor costs and payer-related delays remaining…
Automation with integrity: The real work behind healthcare’s digital transformation
HFMA’s Healthcare C-suite of the Future report captures precisely where healthcare leadership must go, and it’s a direction we at Healthrise have been deeply invested in for years. The industry’s challenges are real: unsustainable costs, workforce strain and mounting pressures on ROI. Yet the transformation underway is also an extraordinary opportunity if leaders can align…
AI coding at UMass Memorial tempers staffing shortage
UMass Memorial Medical Center’s radiology department has been able to sidestep a lack of bill coding professionals by adopting AI in the medical center’s coding for radiology. “It’s really hard to get certified coders these days,” said Barbara Scully, associate vice president, physician billing with UMass Memorial, which is located in Worcester, Massachusetts. “It’s one…
5 keys to enhancing automation, expanding capacity and improving efficiency to reduce costs
Healthcare organizations face unrelenting financial pressures, with rising costs and shrinking margins. Dealing with reimbursement challenges, they face an uphill battle to maintain a profitable revenue cycle. This leaves no room for inefficiency. There is a way out, but healthcare leaders must look beyond traditional methods to automation to expand capacity and improve operational efficiency.
Bridging the gap: Integrating value-based care into revenue cycle management
The idea of value-based care (VBC) has existed for decades but only gained momentum since the 2017 implementation of the Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP). VBC incentivizes providers for quality outcomes, unlike fee-for-service models that reimburse providers for each service performed. The ultimate goal of VBC is to improve…
Vanderbilt Health harnesses data to improve revenue cycle management
Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…