Modernizing RCM with AI

We have addressed the topic of healthcare interoperability in several previous posts, highlighting how important interoperability is to growth in healthcare, how to achieve it, and how it enables healthcare personalization. With all this established, it is important to take a look at how healthcare is able to leverage the data ...

Download PDF Copy of the Newsletter Interoperability Key for Enabling Growth in Healthcare The importance of data interoperability for the healthcare industry should be no surprise by now. When a patient goes from one provider to another -- or visits a hospital for emergency care -- a patient's EHR should ...

Unlocking the immense benefits of data interoperability in healthcare has huge benefits for payers, patients, and every person and organization in between. The challenge is on healthcare IT leaders -- and their technology vendors -- to meet the challenges of interoperability through new innovative technologies to improve patient outcomes while ...

The importance of data interoperability for the healthcare industry should be no surprise by now. When a patient goes from one provider to another -- or visits a hospital for emergency care -- a patient's EHR should be readily available with the most current information so the patient receives the ...

A major topic within the healthcare industry is revenue cycle automation -- particularly with the effects of COVID-19 pandemic pushing employees to remote environments. While there are arguments to be made on what technologies are best suited, it should be relatively clear that the benefits of automation will help propel ...

Download PDF Copy of the Newsletter Industry News: 3M Taps Waystar for Revenue Cycle Automation Healthcare Finance reports that 3M's healthcare division is partnering with Waystar to implement AI automated revenue capture in its over 6,000 health systems and hospitals in the US. According to the article, 3M will leverage ...

Healthcare Finance reports that 3M's healthcare division is partnering with Waystar to implement AI automated revenue capture in its over 6,000 health systems and hospitals in the US. According to the article, 3M will  leverage Waystar's predictive analytics and machine learning algorithms to analyze historical data, identifying patterns to  pinpoint possible ...

Download PDF Copy of the Newsletter The No Surprises Act: Advanced EOBs on the Horizon The No Surprises Act -- which is part of the Consolidated Appropriations Act introduced earlier this year -- is a pretty straightforward proposition: It is designed eliminate some of the surprises that group health plan ...

The COVID-19 pandemic has acted as the "catalyst" that has spurred healthcare digital transformation. With many non-essential workers being moved to remote environments -- possibly permanently -- healthcare providers and revenue cycle companies turned to technology to further ensure that revenue cycle continue its operations. Back in 2019, OrboGraph collaborated ...

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 ...