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Interoperability is game-changing not just in a clinical setting, but it holds tremendous potential for healthcare’s financial stakeholders as well. Prioritize Intake for Effective RCM Patient intake is an important part of the revenue cycle process. The earlier and more seamlessly we can engage, the better.”
Outsourcing will pivot to a more surgical, targeted strategy, focusing on high-impact, specialized areas like revenue integrity, underpayment recovery, and the more commonplace out-of-state Medicaid and small balance recovery work where RCM outsourcing supplements streamlined, automation-empowered teams instead of replacing them.
Read more… An Interoperability and EHR API Deep Dive with Brendan Keeler. In part two of their conversation, John and Brendan touched on the challenges and opportunities of interoperability , particularly from the perspective of prior authorization, along with what to make of information blocking court cases.
The limitations of interoperability has made value-based care more complex , said Ashay Thakurat Cedar Gate Technologies. RCM company CorroHealth finalized its acquisition of Xtend , Navient’s healthcare RCM business. Read more… Breaking Down Healthcare’s Data Walls.
Revenue Cycle Management (RCM): The Strongest Use Case of GenAI in Healthcare The financial backbone of healthcare, RCM, entails everything from payments and pre-authorization before treatment to reimbursements, compliances, and interoperability with other systems. Such applications go beyond automating repetitive tasks.
John connected with Angie Bass at Velatura to discuss why interoperability is about finding value in data and not just exchanging data. RCM automation platform Candid Health announced $29 million in Series B funding. Read more… The Value of Health Data for Business Intelligence.
Tellingly, 60% of recommended imaging isn’t followed up on , and panelists said the one-two punch of limited interoperability and poor engagement play a big part in that. The Healthcare IT Today community expects automation will continue transforming RCM in 2025 , with a primary focus on eliminating waste and reducing inefficiency.
Ultimately, the integration of true AI and machine learning in RCM contributes to greater accuracy, reduced denials, and a better patient experience. The best RCM work is eliminating the work itself, and if the work cannot be eliminated then it’s about automating the work through AI and machine learning models.
Knack RCM acquired HealthyBOS , an RCM vendor with expertise in the durable medical equipment sector. Preventive care AI vendor HEALWELL acquired Orion Health , a New Zealand-based interoperability vendor. Innovaccer acquired Humbi AI , which provides healthcare actuarial software, services, and analytics.
News ASTP released a draft of United States Core Data for Interoperability v6 , with six new data elements. RCM managed services vendor Ensemble received a patent for its data retrieval and decision support technology. The public comment period on the draft is open until April 14, and final release of USCDI v6 is targeted for July.
By adding Corridor to its portfolio, WellSky will expand its medical coding and revenue cycle management (RCM) offerings to help care providers increase efficiency and improve performance across clinical, financial, operational, and compliance areas.
RCM vendor R1 is partnering with Palantir Technologies to launch R37 , an AI lab focused on healthcare financial performance. Interoperability vendor Innovar Healthcare introduced BridgeLink , an open-source fork of Mirth Connect Linus Health launched Anywhere for Health Systems , a Class II medical device offering cognitive assessments.
We recorded many videos with members of our community and other event attendees to get expert analysis on topicssuch as AI, cybersecurity, and interoperability. Read more… Improving RCM With AI. RCM automation vendor Candid Health raised $52.5 The Healthcare IT Today team was out in full force in Las Vegas.
RCM optimization vendor Iodine Software launched Appeals Management Workspace to support denials management. Document exchange and interoperability vendor Concord Technologies launched Concord Connect , which routes patient records to the appropriate system.
A study from CWH Advisors and Synchrony found that 63% of providers have RCM staffing shortages , and 61% expect to work with third parties for help. Product and Company News Interoperability company Lyniate rebranded as Rhapsody , which was the company’s original name before its 2019 merger with Corepoint Health.
The AI models of tomorrow will be fueled by a complete picture of each individual patient this is powered by a responsible infrastructure with an output of safe, and secure interoperable data. AI-powered revenue cycle management (RCM) systems streamline billing and coding processes, reduce claim denials, and optimize revenue capture.
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.
The reason for this is HiMS’ prioritization of interoperability.” ” Through AXiOM, all of COPE’s technologies, including telehealth and revenue cycle management (RCM), can communicate with each other. ” Twitter: @SiwickiHealthIT.
About half (49%) of healthcare professionals are likely to invest in new RCM technology in the next 18 months , according to Salucro’s Healthcare Provider Fintech Insights Report. News and Studies The Sequoia Project released a bundle of TEFCA draft documents , including v2 drafts of the Common Agreement and QHIN Technical Framework.
Read more… EMR and RCM in the Cloud Providing Value to HealthNet. Document exchange and interoperability vendor Concord Technologies acquired Opero , which develops business process improvement applications for Salesforce. Real-time location systems vendor Cognosos acquired Cox Prosight , an RTLS platform for hospitals.
News HHS revealed disincentives for providers that commit information blocking , with organizations subject to lower scores and reduced reimbursements under the Medicare Promoting Interoperability Program and ineligible for MSSP participation for at least one year. RCM services vendor Savista launched Sophia , a patient-facing digital agent.
Hamad Husainy at PointClickCare sat down with Colin and discussed how TEFCA and other regulations are driving interoperability efforts – and how data-sharing is key to reaping financial benefits under value-based care. Read more… The Benefits of an Open, Interoperable Communication Platform. Million in funding.
Read more… The Sequoia Project’s Healthcare Interoperability Roadmap for 2025. We got plenty of good answers, including collaboration, data visualization, decision support, interoperability, and support for third-party apps. Read more… Using RCM Technology to Close Healthcares Generation Gap.
Who better to talk to the Healthcare IT Today community about interoperability than the National Coordinator himself? Read more… The Role of Innovation and AI in RCM. Read more… Seeing How Patients Experience RCM. John also asked the experts what RCM looks like to patients.
The following is a guest article by Austin Ward, Head of Growth at Fathom In the face of workforce shortages and increasing cost pressures, many organizations are turning to AI technologies to automate revenue cycle management (RCM) processes. Automation Rate The most important criterion for AI in RCM is the automation rate.
In addition, interoperability vendor Secure Exchange Solutions joined the MEDITECH Alliance Collaborator Program. RCM vendor TruBridge received the Peer Reviewed by HFMA designation. Partnerships Redox is partnering with Snowflake to make data from legacy healthcare systems available in Snowflake’s Healthcare & Life Sciences Cloud.
As electronic health record (EHR) systems become nearly universal and interoperability initiatives gain momentum, many healthcare providers assume their revenue cycle challenges are solved. The following is a guest article by Frank Forte , CEO at EnableComp The healthcare revenue cycle has never been more complex.
Interoperability vendor Connective Health is partnering with Availity , a real-time information network, to create precise care summaries for primary care and virtual specialty care providers. Clinically integrated network Southern New England Healthcare chose athenaOne for EHR, RCM, and patient engagement.
Several people mentioned AI and technology infrastructure ; other concerns included nurse burnout, staffing shortages, and interoperability , the age-old topic. Read more… How Interoperability and Analytics Change the Nurse Call Paradigm. Read more… A Look at RCM, AI, and a New Book Called Joy Notes.
We kick off this episode by discussing how South Shore Hospital is positioning itself in the rapidly evolving landscape of healthcare interoperability. Next, we discuss how interoperability influences the hospital’s strategies and operations. What’s the best piece of advice you’ve been given in your career?
The Sequoia Project has released additional documentation support the implementation of TEFCA , the Trusted Exchange Framework and Common Agreement for health IT interoperability. Illinois-based Midwest Orthopaedic Center went with eClinicalWorks for its patient engagement, cloud-based EHR, and RCM products.
Read more… Collaboration Across the Healthcare Ecosystem Is Key to RCM Success. Organizations are evolving data strategies to meet the demands of a digital-first future – but they also need to consider the demands of legacy infrastructure and interoperability, said Gurpreet (G.P.) Singh at ELLKAY.
Cybersecurity, privacy, and interoperability represent the biggest hurdles that vendors will need to overcome. RCM vendor Access Healthcare acquired Envera Health , a patient engagement vendor. Community care coding and RCM company WellSky acquired Corridor , a service partner for post-acute care.
Lack of Interoperability Brings Labor-Intensive Workflows Despite the high costs of healthcare in the United States relative to other nations , the country is known for its cutting-edge and innovative treatments. This lack of code interoperability creates paperwork challenges for American hospitals seeking payment from other nations.
Earlier this month, the RCM vendor reported a data breach that may have impacted patients at five Texas-based providers. Dr. McGill talked to John about whether data sharing and interoperability are still priorities for health systems , along with what emerging technology has him excited. How do we give everyone the time to learn?
Revenue cycle management (RCM) is a big HIMSS theme from providers’ points of view. Can we even imagine the bedfellows, strange or not, that will be collaborating for health-tech interoperability and consumer-facing care twelve months from now? The patient as payor. That was tweeted ten years ago.
Only 43% of hospitals routinely engage in interoperable data exchange , according to the latest ONC data brief. RCM vendor Ensemble Health Partners achieved HITRUST Risk-Based, 2-year Certification for its EIQ platform. National physician network Stratum Med adopted Nabla for ambient AI.
Scott Sirdevan at Vorro explained how EiPaaS leads to low latency and better interoperability, all while improving security. RCM automation company Thoughtful AI raised $20 million in Series A funding. Read more… Enterprise Integration Platform as a Service Brings Scalability, Agility to Healthcare Operations.
At its client conference, TruBridge announced a new analytics suite, an interoperability platform, and integration with Nuance Dragon. Integrated provider, pharmacy, and medical equipment supplier American Medical Administrators is implementing eClinicalWorks EHR and RCM. He’s currently CTO at Innovaccer.)
Read more… 2024 Health IT Predictions: Interoperability, Data, and the Cloud. Our experts agreed that interoperability isn’t a goal unto itself but will continue to support efforts to provide clinicians with context at the point of care and make it easier for organizations to advance their cloud strategies.
News CMS has opened the Hardship Exception application period for eligible hospitals and critical access hospitals (CAHs) that participated in the Medicare Promoting Interoperability Program in 2022. EHR and RCM vendor for therapy and rehab practices Raintree released Raintree Payments.
Achieving Interoperability One Practical Byte at a Time. Upstate New York’s Rochester Regional Health began its interoperability journey with lab data , Colin Hung learned, as there was a clear need to bring in lab test results from many external sources to help care teams make better clinical decisions and improve outcomes.
RCM outsourcing vendor Ensemble Health Partners expanded its partnership with Microsoft. Interoperability vendor Innovar Healthcare released an OSS Mirth Connect plugin that’s now available on AWS Marketplace. In other news, Quantum Health launched Premier Oncology , a cancer care navigation tool.
Jill DeGraff at b.well Connected Health provided John with insight into how interoperability could result in a connected healthcare ecosystem. Read more… From Information Blocking to Information Sharing: A Look at HTI-1 and TEFCA.
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