AI and Automation in Revenue Cycle Research
A survey of 272 healthcare executives was conducted to understand how automation and AI are being utilized in their organizations and if not, what barriers or concerns they have to adopting new technologies.
How enhanced medical documentation can combat rising payer denials
Hospital executives across the country are increasingly frustrated with rising denial rates from payers. At a recent HFMA conference, revenue cycle leaders voiced concerns about what they perceive to be bad-faith payer denial practices. Although such frustrations have some validity, hospital leaders will accomplish little if they focus solely on payer behavior. Instead, they should…
New research report: Payer Provider Relationships
Review the results of a survey that explored executives' views on how AI could improve the payer-provider relationship and optimize revenue cycle management. Furthermore, learn about AI adoption within health systems.
Boost charge capture by bridging gaps between teams
This whitepaper identifies some of the most common underlying issues driving charge capture mishaps — and outlines a new path forward optimizing charge capture.
Why it’s important to understand friction around claims denials
Payment for healthcare services starts with a claim that details what type of care the patient received, why and the amount charged by a hospital or provider for these services. From there, the claim is typically sent to the patient’s health plan for reimbursement. But the path to reimbursement for healthcare claims has become much…
Optimizing the revenue cycle workforce: Balancing automation with empathy to elevate the patient experience
In today’s healthcare landscape, every financial conversation shapes not just patient satisfaction, but organizational trust. As health systems work to manage rising costs and operational complexity, revenue cycle teams find themselves carrying the dual burden of protecting financial performance while supporting patient experience, often without the resources to excel at either. Automation presents undeniable advantages…
Soaring charity care grabs hospital leaders’ attention
Across the country, hospitals are reexamining their approach to uncompensated care, with first movers in this space increasing the availability of financial assistance and working harder to reduce the chances that an account will be sent to collections. And now, new data paints a picture of the collective impact of these efforts and other trends…
Reeling payers plan to increase scrutiny of providers’ coding practices
Health insurers see provider coding practices as one factor in unfavorable cost trends, several companies said during recent earnings calls. Those cost trends, in turn, have driven substandard Q2 financial results. “We know this adjustment is disappointing, and we’re taking concrete actions to address it,” Gail Boudreaux, president and CEO of Elevance Health said recently,…
Why this year’s OPPS rule could have a big impact
Nick Hut and Shawn Stack talk about the 2026 Medicare proposed rule for the Outpatient Prospective Payment System and why it could have a more significant impact on hospitals than rules from previous years. Also in this episode, Aneal Gadgil from Abridge discusses clinical documentation and coding.
Get paid what you’re owed: Smarter contracting, internal alignment can reduce denials
Hospitals and health systems are grappling with rising denial rates, particularly among commercial and Medicare Advantage plans. Years ago, denials might have been isolated friction points in the billing process; but as rates have risen, denials have become a strategic-level issue with a measurable impact on financial performance. Historically, denial mitigation efforts tended to focus on…