Modernizing RCM with AI

Last week on the OrboNation Healthcare Payment blog, we touched upon the topic of Advanced EOBs -- an initiative from The No Surprises Act, which goes into effect January 1, 2022. But what is an Advanced EOB? According to the JDSupra site in collaboration with Holland & Hart, a Law Firm with expertise in ...

According to a survey conducted in April to May of 2021 by Harmony Healthcare, hospitals' denial rates have reach new highs during the pandemic. As reported by Fierce Healthcare: 33% of the poll's respondents reported average denial rate exceeding the "denials danger zone" of 10% 16% of the poll's respondents ...

Download PDF Copy of the Newsletter How AI is Driving Patient Financial Experience Excellence It's no secret to anyone who's read previous posts here that artificial intelligence (AI) and machine learning are a boon for revenue cycle management -- probably one of the strongest use cases for this type of ...

For Revenue Cycle Outsourcers -- RCM companies, clearinghouses, billers, and medical lockbox providers --  the quandry is this: What do healthcare providers evaluate in their decisions to outsource their revenue cycle operations? An article by revcycleintelligence.com cites a report by KLAS on the importance of this decision: "Entrusting your organization's financial health ...

Artificial, a software company providing a first-of-its-kind lab automation platform, recently announced the close of $21.5M Series A investment round. The round was led by M12, Microsoft's venture fund, along with Playground Global and AME Cloud Ventures. "Artificial's aLab Suite is especially exciting to us because it is uniquely positioned ...

A recent article from RevCycleIntelligence.com focuses on a new report published by Deloitte -- and the predictions are a stark contrast to the current business model for healthcare. In a new report, experts estimated that healthcare spending will be $83 trillion by 2040, about $3.5 trillion less than what CMS actuaries estimate using ...

On February 24, 2021, 3M Health Care -- in collaboration with Becker's Hospital Review -- hosted an informative webinar focused on the importance of an efficient revenue cycle and how artificial intelligence is the key technology factor to increase productivity in that area. The webinar features three speakers with decades ...

Revenue Leakage continues to be a major challenge for revenue cycle management, as billions of dollars are left unaccounted for each year. In fact, this issue has been growing over the past two decades, with $41.61B in uncompensated care in 2019 -- according to the American Hospital Association. This is ...

Continuing our mission to bring to our readers news, trends, and insights on how Artificial Intelligence, Deep Learning, Machine Learning, and other technologies are advancing the revenue cycle management and healthcare payments industries, this week's article from Modernizing RCM with AI brings to you a Unique Case Study of 3 Major ...

We recently covered the difference between digitization and electronification in Modernizing RCM with AI and why electronification is the choice more often made by the healthcare industry. It comes as no surprise that R1 RCM is onboard as well, spreading the message that integrating "intelligent automation" is the key factor ...

In a recent press release, Change Healthcare released findings from their Poised to Transform: AI in the Revenue Cycle -- a national study of 200 revenue cycle, IT, finance, and C-suite decision makers commissioned by Change Healthcare (Nasdaq: CHNG) and conducted by market researcher ENGINE Insights. According to the press ...

The mission of Modernizing RCM with AI is to bring to our readers news, trends, and insights on how Artificial Intelligence, Deep Learning, Machine Learning, and other technologies are advancing the revenue cycle management and healthcare payments industries. We've presented information from myriad industry sources, but we would be remiss ...

With the start of the new year, R1 RCM has set a lofty goal for itself. According to an article on Becker's Hospital Review, during their presentation at the 39th JPMorgan Healthcare Conference, R1 RCM is forecasting $4B in new patient revenue for 2021 -- an increase of $1B over ...

The healthcare payments industry is filled with optimism as we kick off a new year with COVID-19 vaccines being administered across the globe. The industry faced many challenges throughout 2020, but healthcare technology companies stepped up and transformed the pandemic into an opportunity to innovate, calling the pandemic a "catalyst" ...

In a recent post, we noted that the COVID-19 Pandemic has accelerated healthcare's digital transformation. While many healthcare organizations were already in the midst of technological innovation projects, the pandemic became the "catalyst" to speed up the process. This was certainly the case when it comes to the partnership between ...

Speaking with PYMNTS.com, John Innes, CEO of ACH Process Company,  described how the virtual card is sometimes an ideal payment method to optimize payment flows and support the cash flow for both ends of a B2B transaction. Traditionally, healthcare payments between healthcare insurance companies and Third Party Administrators (TPAs) came ...

In a recent webinar with Teleperformance Group -- a worldwide leader in multichannel customer experience -- Christoper Giuliano, vice president of finance, specialty revenue cycle at CVS Health provides an in-depth overview of CVS Health's journey towards automation for their back-end processes and the go-forward strategy for 2021 and beyond. ...

Employee productivity, especially during these unprecedented conditions where remote environments are becoming more common, is a top priority for healthcare RCM. The COVID-19 pandemic has spurred many organizations to adopt productivity monitoring software on employee laptops. However, there are some reports that these types of software hurt employee morale and ...

The COVID-19 pandemic has altered the ways healthcare organizations -- in particular healthcare RCM -- operate, as many businesses shut down office locations and move to remote environments to ensure employee safety and to slow the spread of the virus. While this has altered the way RCM operates from a ...

We've covered many different topics on Modernizing RCM with AI over the past year, providing readers with: Information and education on Artificial Intelligence (AI) and Machine Learning (ML) technologies Insights from industry experts on how to utilize AI and ML Different use cases of healthcare organizations leveraging AI and ML ...

Having already announced our client and partner virtual technology conference in late September, OrboGraph has completed it’s speaker line-up for the ORBOIMPACT conference for the afternoons of October 29th and 30th (see agenda here). Day 1 (Thursday, Oct. 29): Healthcare Payments Sessions Day #1 is highlighted by Keynote speaker Mr. Michael Manna at ...

A survey conducted through the Healthcare Financial Management Association's (HFMA) Pulse Survey program and sponsored by Alpha Health provides intriguing insights into the direction of the new reality of RCM. The purpose of the survey -- conducted between May 19, 2020 to June 22, 2020 -- was to assess the ...

AI is no longer a nice-to-have in healthcare; it’s a necessity. - Shashi Yadiki, President, Health Plans, NTT DATA Services In a discussion with Modern Healthcare, three healthcare industry leaders -- Peter Durlach, SVP, Healthcare Strategy & New Business Development at Nuance Communications, Inc.; Scott Weingarten, M.D., MPH, Chief Clinical ...

Although technology companies promise near-magical results from AI, the notion that AI will transform healthcare and eliminate most positions is a bit far-fetched. This misconception is addressed in the Healthcare IT News report and provides an interesting perspective from an expert panel during the HIMSS & Health 2.0 Europe Digital Conference. ...

What is the difference between digitization and electronification?  Many believe that the process and purpose are basically the same. We are here to clear up that misconception. What is Digitization? Let's first take a look at digitization. According to an article at Forbes.com, Gartner IT Glossary defines digitization as: "Digitization is ...

With myriad buzzwords and technologies swarming the healthcare industry, especially in revenue cycle management, it's become even more difficult for many to understand and identify which technologies are the most useful for their particular business or process. Fear not -- we are here to help cut through the clutter and ...

Most people are aware of misleading communications from third parties. They are created to look as official as possible, and many are under the impression that these communications are from official government entities and require action be taken to ensure compliance. While most of these communications are sent via digital ...

Healthcare professionals across the globe are taking to the social media platform TikTok to spread a bit of joy with others by performing everything from a short dance clip! And, in a time where many people are choosing at home as much as possible, who couldn't use a smile and ...

Industry and news outlets across the US -- and even the world -- continue their ongoing coverage of the COVID-19 Pandemic. However, for many of us who work within the healthcare industry, there are many other headlines that catch our attention. We would be remiss to not focus our attention ...

There are a plethora of technologies and technology companies in the market providing myriad products and services to help optimize RCM for healthcare. However, aligning these technologies to meet the needs of RCM is crucial for healthcare organizations and RCM servicers. Healthcare IT News brought together five revenue cycle technology ...