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Revenue Cycle Management (RCM) is like a one of those huge Lego sculptures. Having a well executed RCM strategy is crucial to keep your organization running because it impacts everything. From the outside it looks one thing, but upon further inspection there are a million tiny little pieces that fit together to create the whole.
John Waters, Director, Revenue Cycle Product at CliniComp AI can be used in the RCM world to solve two overarching themes: inefficiencies in workflow, and errors that cause delays in payment. AI facilitates real-time data analysis, providing clinicians with instant access to patient histories, lab results, and treatment plans.
AI-powered revenue cycle management (RCM) systems streamline billing and coding processes, reduce claim denials, and optimize revenue capture. These AI tools and more are having a tremendous impact on multilingual information capture in the EHR to facilitate higher accuracy levels of interpretation and translation at the point of care.
RCM will be managed by AI-powered agents every step of the way, including generating appeals letters, submitting appeals to payers, and converting paper EOBs to ERAs. In 2025, we predict that using AI-powered agents will reduce the cost of Revenue Cycle Management (RCM) by 70%, helping streamline the end-to-end billing process.
Nearly all (95%) of healthcare executives are interested in end-to-end managed services to solve RCM challenges, according to a survey from Ensemble Health Partners. An analysis from Brooks Rehabilitation found that Connecticut has the highest fall treatment costs , at nearly $13,000, due in part to a scarcity of physicians.
Products Avo launched Ask Avo , an AI tool for clinical consults that integrates with EHR systems. Clinically integrated network Southern New England Healthcare chose athenaOne for EHR, RCM, and patient engagement. Virginia-based Mary Washington Healthcare chose Ensemble for RCM.
News and Studies Follow-up rates for telehealth and in-office visits have remained consistent since 2020 , according to analysis from Epic Research. GLP-1 agonists have overtaken insulin in total prescriptions and cost among commercially insured patients , according to an analysis from Cedar Gate Technologies.
Lenovo unveiled Lenovo Hybrid AI Advantage with NVIDIA solutions, with use cases including MRI scan analysis. RCM vendor R1 is partnering with Palantir Technologies to launch R37 , an AI lab focused on healthcare financial performance.
Read more… Cybersecurity, AI, and the Future of RCM. Colin Hung interviewed Michael Quinn at Inovalon about why humans remain key to RCM even as automation takes hold. In part two, Andy dove into how analysis of biomarkers can influence treatment plans and provide personalized, holistic recommendations.
Dr. Seth Eaton at pediatric provider MedPeds talked to Colin about using AI to read faxes, match them to patients, and insert the fax into the right record in the EHR. Lung and head imaging analysis vendor Qure.ai Read more… Bringing the Fax into the 21st Century. Read more… The Impact of Effective Revenue Cycle Management.
The Global Software report recognized regional leaders in acute care EHR and PACS. The latest analysis from Epic Research found most GLP-1 medications are correlated with lower likelihood of anxiety and depression , which are common side effects of the GLP-1 Wegovy (semaglutide). For the U.S.
The push to adopt EHR and RCM technology in acute care has left other care settings underserved , with adoption under 50% in post-acute care, primary care, and rehab, according to the latest HFS Research report. Bizmatics is integrating DrFirst ‘s RxInform patient engagement tool into its PrognoCIS EHR.
Bloomlife and PeriGen are partnering to improve access to monitoring and data analysis for of high-risk pregnancies. New England Orthopedic Surgeons (NEOS) is implementing athenaOne EHR, RCM, and patient engagement functionality. Data platform Arcadia has joined the Atropos Evidence Network of evidence-generating applications.
The analysis also found that Z-codes are most frequently used in behavioral health and acute care settings. Partnerships Patient education and engagement vendor Mytonomy has connected Mytonomy Cloud for Healthcare with Oracle Health EHR. EHR and RCM vendor for therapy and rehab practices Raintree released Raintree Payments.
A data analysis from Cedar Gate Technologies found a 9% increase in 90-day prescriptions for managing chronic conditions such as high blood pressure, arthritis, and diabetes. SYNERGEN Health and HST Pathways are partnering to bring RCM software and services to ambulatory surgery centers. A March of Dimes report found 35% of U.S.
More than 85% of health systems are increasing IT and digital budgets for 2024 , a Guidehouse analysis found. Cybersecurity tops the list of investment priorities, followed by EHR modernization, virtual / digital care, and AI. RCM is by far the most popular potential use case, with 58% of all considering the use of generative AI there.
Read more… What the Latest CMS Data Standards Mean for EHRs. In the latest installment in our Healthcare Regulatory Talk series, Dr. Nick Barger at DrFirst explained why EHR developers need to be flexible enough to adapt to ever-changing standards and shouldn’t be looking at standards one at a time.
Read more… Uncovering Diagnostic Information in the EHR. Eli Ben-Joseph at Regard talked to John about the benefits of analyzing EHR data to find old data relevant to new treatment , along with the importance of making this functionality available with a single click. Read more… CIO Podcast : Patient Engagement.
Read more… Learning From Consolidating EHRs and Achieving HIMSS Stage 7. In the latest CIO Podcast, LCMC Health’s Tanya Townsend told John about the health system’s EHR consolidation as part of its effort to get to HIMSS Stage 7 for the EMR Adoption Model. Read more… Taking SDoH From Data to Analysis to Action.
Read more… Gaining More Control With a Cloud-Based EHR. Moving to the eClinicalWorks Cloud EHR simplified the IT environment – and improved account management and authentication. RCM vendor Aspirion acquired FIRM Revenue Cycle Management Services. Read more… Determining the Next Best Step for Member Care.
Hint Health debuted Hint All-in-One , an EHR, practice management, and patient communications app for direct primary care. AdvancedMD announced its 2023 Spring Product Release , with 31 updates across EHR, practice management, and patient engagement functions. People Consultancy AVIA appointed Scott Cullen, M.D.,
The market will see increased asks/attention for bots as they are critically needed in RCM to offset staff shortage, enhance staff retention, and accelerate tasks (ultimately cash flow). In the future we will see even more connected devices sharing data and fueling diagnostically focused EHRs.
The report also finds that providers are prioritizing their IT investments in certain key areas, such as: Revenue cycle management (RCM) : RCM is the process of managing the financial aspects of patient care, from billing and coding to collections and denials. Market Insights & Analysis for Founders & Investors.
hospitals are losing money, a Kaufman Hall analysis shows, even at a time when overall hospital margins are growing. Go Beyond Your EHR While an EHR might offer traditional methods for digital communications with a “portal,” community hospitals need more than a standard, “good enough” approach.
After wearing the monitor for the prescribed wear time, the patient removes it and mails it back to iRhythm, where the company’s patch intake centers compile the data for analysis by the DNN and curated by ECG experts to produce a customized final report for physicians.
Dental software maker Henry Schein One is partnering with VideaHealth to release AI-enabled X-ray analysis tools. Urgent care EHR vendor Experity appointed Dr. Benjamin Barlow as Chief Medical Officer. French cancer center Gustave Roussy Institute chose Synapse Medicine for clinical pharmacy and medication reconciliation services.
Organizations have traditionally sought to use prescriptive analysis: for instance, using historical information to identify at-risk patients or to aid diagnosis. These can look at EHRs and patient directories, or analyze 60-70 pages worth referral documents to identify the need for financial planning.
The number of individuals impacted by healthcare data breaches is up 56% from last year , according to a Fortified Health Security analysis of HHS data. Pennsylvania-based Universal Health Services is expanding its Oracle Health EHR deployment to more than 200 behavioral health facilities.
Orlando Health selected Biofourmis for vital sign monitoring and analysis for its hospital at home program. EHR, RCM, and practice management software vendor Greenway Health named Mark Goodwin as Senior Vice President of Revenue Services. Bellin Health chose Kyruus ProviderMatch for patient digital access and self-scheduling.
News and Studies Nearly two dozen health systems have pledged to use Epic to share health information through the TEFCA framework , the EHR vendor announced, adding, “Our plan is to deliver software this year that will help our customers to be among the initial participants in TEFCA.”
Interoperability vendor Particle Health launched Particle for Platforms , a single API layer that enables connections to Inovalon RCM Intelligence is now compatible with all electronic data interchange claims clearinghouses. The company also announced that the Princess Alexandra NHS Trust is migrating to the Oracle Health EHR.
South Dakota-based Sanford Health selected Availity Essentials Pro for RCM. California-based in-home post-surgical rehabilitation provider GrandCare Health Service selected Homecare Homebase for RCM. Healthcare Therapy Services selected OneStep for motion analysis to help therapists detect fall risks in older patients.
The following is a guest article by John Wallace, PT, OCS, Senior Vice President of RCM at WebPT. Medicare’s Targeted Probe and Educate audits use data analysis to identify clinics who have high claim error rates or unusual billing practices. After all, more patients should generate more billable services—and thus, more payments.
Colin summarized the keynote from longtime CEO Girish Navani, highlighting how eClinicalWorks is using AI to power search functions within the EHR, augment tasks such as appointment scheduling, and generate patient summaries – and bring this functionality to community health centers and FQHCs, roughly 60% of which use the eCW platform.
In the spirit of prevention of burn out, where technology can automate administrative burden, make chart reviews more efficient, use ambient listening capabilities to reduce time spent in the EHR will have a positive impact on the clinical burnout epidemic. The friction between healthcare providers and payers remains a significant challenge.
Health system data network Truveta unveiled the Truveta Language Model, which turns EHR data into data points that can be used for health outcomes research. MediMergent implemented its platform for the collection and analysis of real-world data in a multi-center clinical trial. In addition.
An analysis of 12 million commercial members from value-based care platform Cedar Gate concluded that inpatient surgery volumes decreased more than 7% from 2019 to 2021. EHR, RCM, and practice management vendor ModMed appointed Jody Beaverson as Chief People Officer. DrFirst promoted G.
We heard about the benefits of access to real-time data, the importance of data standards, and the need for mature data analysis and data management infrastructures. Helping clinicians troubleshoot within the EHR can improve workflows and job satisfaction , Bill Lewkowski at HCTec pointed out. million in seed funding.
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