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Survey: How Can AI Transform Revenue Cycle Management Technology?
In a survey of 125 people who work in medical billing, respondents shared what they like and dislike about the medical billing status quo and the changes they’d like to see to transform medical billing into a seamless operation.
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RCM Outsourcing: Balancing Human Expertise & Smart Technology
Greenway Health blends smart technology with human expertise to elevate revenue cycle.
Payment Integrity is a Systems Problem, not a Data Glitch
As our healthcare system has evolved to provide higher quality care to more — and increasingly clinically complicated — people, the disconnect between what’s billed, what’s documented, and what’s actually true has deepened.
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Refining the Medical Billing Infrastructure to Reduce Payment Bottlenecks for Providers and Payers
Yusuf Qasim, President of Payments Optimization at Zelis, discussed how the company is transforming healthcare payments from a fragmented, patchwork system into a modern, digital infrastructure.
Why US Healthcare Billing Needs an Overhaul
Current billing practices do not adequately meet the needs of consumers, providers or payers. While there is no magic wand, reinventing billing processes in the US will require measures that strengthen consumer protection, and continued policy change towards fairer drug pricing and increased price transparency of provider service costs.
Mass General Brigham-Born Revenue Cycle Company Snags $55M
CodaMetrix, an AI platform for hospital revenue cycle management, recently closed a $55 million Series A funding round. The company, which was launched out of Mass General Brigham in 2019, is focused on simplifying the complicated process of translating patient records into codes for billing and clinical research.
NEMT Partner Guide: Why Payers and Providers Should Choose MediDrive’s TMS
Alan Murray on improving access for medical transportation.
Elation Health Buys Medical Billing Company to Create All-in-One Tech Platform for Primary Care Providers
Elation Health announced its acquisition of medical billing company Lightning MD — a deal the company made to help it become an all-in-one technology platform for primary care providers. Lightning MD stood out from other medical billing startups because of its ease of use, Elation CEO Kyna Fong said.
Panel Orders UnitedHealthcare to pay $10.8M for Allegedly Underpaying Physicians
The lawsuit is one of nine cases throughout the country that TeamHealth has brought against United for alleged underpayments. The other eight cases are still ongoing.
What will the next generation of medical coding look like?
A transformation is underway in medical coding as automation permeates revenue cycle management, raising questions such as: How will automation affect how medical coders work? How advanced is coding automation currently? What kind of skill sets will be needed for these new types of coding?
How to meet the demands of the No Surprises Act
Patients deserve high-quality care and better outcomes, as well as equitable, consistent and transparent billing experiences. So how do we get there?
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Could QuantalX’s Device Make Managing Brain Health Easier?
CEO and neuroscientist Dr. Iftach Dolev on how the new device can bring a powerful tool to psychiatrists and neurologists alike.
Demystifying digital patient financial engagement: 4 ways AI can help
When designed effectively, digital payment and financial communications can have a substantial impact on a hospital or health system’s bottom line. But patients still commonly receive their bills by mail.
What does the federal ‘No Surprises Act’ mean in California?
Betty Chow, a Los Angeles resident, had a cervical disc replaced in August 2020 at a surgery center that was part of her Anthem Blue Cross PPO network. Thirteen months later, she was blindsided by a bill for nearly $2,000 from the anesthesiologist who was on her surgical team but was not contracted with her […]
Preparing for the No Surprises Act: How automation can help solve the provider directory problem
The deadline to comply with the No Surprises - January 1 - is practically around the corner. Payers that want to be in compliance with its provider directory provision must act now.
How CMS final rule will impact E/M coding and documentation requirements
Historically, providers had to meet certain criteria and address three key areas in the patient’s progress notes: patient history, physical exam and medical decision making. CMS has eliminated the history and exam components as required elements for billing purposes, so medical decision making is now the sole driver of the level-of-service.
Vivor CEO highlights patient financial assistance platform for hospitals and health systems
Vivor CEO and Co-founder Ian Manners talks about the origins of the financial assistance startup and their mission to eliminate out-of-pocket costs as a barrier to care.