From back office to balance sheet: Why revenue cycle is becoming strategic AI infrastructure
Healthcare finance leaders are confronting a new reality: Revenue cycle performance now directly influences organizational stability, capital planning and access to care. Rising denial rates, expanding prior authorization requirements and persistent staffing constraints have transformed revenue operations from a transactional function into a strategic enterprise capability. Recent reporting from Kaufman Hall shows denials and revenue…
Cutting through the clutter: Practical strategies to reduce administrative waste in payer-provider interactions
Administrative costs in healthcare continue to rise, often consuming more resources than direct patient care. Nowhere is this more visible, or more solvable, than within revenue cycle management (RCM). These costs are not just a patient care concern; they strain the workforce and directly impact financial sustainability. Much of the challenge stems from a persistent…
Navigating medical necessity denials: Strategies for successful resolution
Just as hospitals, health systems and physician practices are dealing with unprecedented financial and operational challenges, denied claims continue to rise — especially medical necessity denials. The impact on providers and patients is significant. Medical necessity is the term used to describe “healthcare services or supplies needed to diagnose or treat an illness, injury, condition,…