Panel: AI can improve prior authorization in healthcare but won’t solve all the issues
New approaches to prior authorization are crucial to improve a process that remains essential to supporting healthcare quality, according to a subject matter expert. “Prior auth exists because there’s a bell curve of care in the United States,” said Jeremy Friese, MD, founder and CEO of Humata Health, referring to substantial variability “from a safety…
How to use an enterprise approach in implementing AI in RCM
Revenue cycle transformation has long been framed as a matter of technological advances. But in the AI-fueled era, the differentiator is shifting from individual technologies to enterprise operating model redesign, according to leaders from Mayo Clinic and Jefferson Health. They described how their organizations are repositioning revenue cycle as a core component of care delivery,…
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…
Automating mid-revenue cycle workflows: What to consider
In this HFMA executive roundtable, 11 healthcare revenue cycle and health information management executives share how they’re implementing AI solutions and shifting traditional staffing strategies as these new tools take hold.
AI Adoption in denials management lags as other RCM uses expand
Denials management, one of the toughest tasks in hospital revenue cycle management (RCM), deserves more attention from AI experts, but RCM execs are not diving in with AI solutions for multiple reasons. About one in five healthcare providers apply AI to denials management, a 2025 Bain & Co. survey found. Instead, providers have turned more…
Battle of the Bots intensifies over denials
Healthcare payer claim denials are getting smaller, sneakier and faster. The battle of the bots over healthcare claims payment delivered record blows in 2025, with initial denials sometimes occurring within seconds of submission.a “Payers are becoming more sophisticated in their use of AI, and the denials are coming faster than we can keep up,” said…
Affordability under pressure: How hospitals are responding to rising patient cost burdens
When the initial shock of a Stage 4 colorectal cancer diagnosis wore off, Tampa Bay, Florida, resident Tim McDonald, 57, says a new devastation quickly set in: The cost of what it might take to save his life. McDonald has been outspoken about his experience in dealing with colorectal cancer and has become a strong advocate for education…
Tips for healthcare leaders on choosing the right RCM partner
Read about how one company enables healthcare leaders to focus on strategic priorities — expanding access to care, improving patient experience and sustaining financial health.
Healthcare providers debate ways to offer patients manageable payment options
Dive into the top insights from several healthcare finance executives who discussed their work in improving the patient financial experience and the growing role of patient financing.