Building Confidence in the Transition to Autonomous Coding
Learn how organizations expanded career opportunities, redesigned auditing processes, and gained buy-in from coders, executives, providers, and vendors to successfully adopt autonomous coding technology.
Prevent denials by catching credentialing issues
Verifying the credentials of ordering physicians should be an essential part of revenue cycle management, and it could prove to be a fruitful endeavor. Ximena Restrepo, compliance and privacy partner for Billings Clinic–Logan Health, which serves residents of Montana and Wyoming, said Billings-Logan has saved thousands of dollars in avoided claim denials or in avoided…
Prior authorization is draining revenue, which is why automation has become a strategic imperative
Prior authorizations have entered a different era. The process has become one of healthcare’s most expensive administrative bottlenecks, affecting far more than physician practices. Across hospitals and health systems, it slows patient access, adds labor-intensive work, increases denial risk, and puts pressure on reimbursement and cash flow. For organizations focused on growth, margin, and operational…
Focus on patient care and access transcends hospital-centric model
Healthcare is shifting from a hospital-centric model to a more distributed, digital and patient-focused system, requiring revenue cycle management to evolve into a strategic enterprise capability. By leveraging AI, automation and revenue cycle data, health systems can reduce barriers to care, improve patient outcomes and strengthen financial resilience amid growing operational and reimbursement pressures.
A New Approach to Drive Best in Class Revenue Cycle Performance
Download this white paper to learn how adopting administrative autonomy, shifting from reactive denial recovery to proactive, AI-enabled prevention, reframes revenue cycle management as an enterprise operating model issue, enabling faster cash flow, reduced denials, and sustainable financial performance.
How to handle the revenue cycle skills gap
Revenue cycle management is becoming less about managing transactions and more about technology, as hospital finance departments shift toward AI-enabled workflows. Increasingly, skills valued by hospital and health system employers are aligning around automation and analytics. As Heather Dunn, chief revenue officer at Novant Health, said in “The Revenue Cycle of the Future,” a recently…
4 shifts that define the revenue cycle of the future
AI can improve patient access, coding, billing, and payment, but CFOs need a revenue cycle operating model built for scale, trust, and governance.
The Revenue Cycle of the Future: AI boom and workflow redesigns accelerate rev cycle transformation
Hospitals of all sizes are leveraging AI advancements and workflow redesigns to modernize revenue cycle management, aiming to lower costs, improve operational efficiency, and enhance the patient experience. While technology such as predictive analytics and automation shows promise in streamlining tasks, challenges remain in workforce adaptation, skill shifts, and the need for strategic collaboration, as leaders work to balance innovation with employee training and retention in an increasingly tech-driven environment.
Fee-for-service payment approach creates obstacles to AI adoption by physicians
AI is poised to transform how healthcare is provided and paid for, but the commonly used fee-for-service (FFS) model of reimbursement could be a problem in getting physicians to adopt clinical AI tools, a group of researchers has found. The sticking point is that when a physician uses AI clinical technology or software in an…
The KPIs that define revenue cycle excellence
Revenue cycle leaders face significant challenges with shrinking reimbursements, rising denials, and operational complexities, requiring more than basic reporting for improvement. The HFMA MAP Keys provide a standardized framework for measuring performance, helping organizations align on key metrics to drive actionable insights and benchmark revenue cycle management effectively.