Tucson Gastroenterology seemed to have their billing system well in hand, staffed with professionals that had long association with the organization and deep knowledge of their methodology and procedures. What could go wrong? Well, as examined at RevCycleIntelligence, those experienced in-house professionals eventually had to retire, handing a complex (and somewhat intuitive) set of instructions…

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 participants encounter from unexpected charges. Health Affairs This Week Podcast provides a tidy summary of the act. An initiative that affects revenue cycle needs further discussion : Advanced EOBs.

This comes as no surprise to anyone in the industry: The COVID-19 pandemic did a number on the healthcare economy, ravaging volumes, revenues, and other financial metrics. We may be on our way to recovery, however. Kaufman Hall’s latest Hospital Flash Report paints an optimistic picture, reporting increases across hospital volumes, revenues, and margins last month compared…

In case you missed it, over the past month, we have published incredible content on our OrboNation Blog and Modernizing Omnichannel Check Fraud Detection. Review the latest OrboNation Newsletter online or via PDF download.

RevCycleIntelligence reports on a new survey that shows about three-quarters of hospitals and health systems in the US deployed revenue cycle management (RCM) technology or underwent active technology deployments during the COVID-19 pandemic. The survey polled over 350 CFOs and revenue cycle leaders at hospitals and health systems between December 17, 2020, and Feb 5, 2021, using…

Already picking up steam pre-pandemic, healthcare consumerism has been hastened by the COVID-19 crisis. RevCycle Intelligence spoke to Kathy LeBrew, chief system revenue cycle officer at University Hospitals in Ohio, about how best to address this new state of the industry. “We need to recognize what’s important to the patient as a consumer, caring about…

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 technology, in fact, as reported by RevCycle Intelligence. “Integrating artificial intelligence into an RCM solution allows us to have data driven approaches to automate each step in the process, whether it's when that first letter is going out, that first contact is happening, or that payment is going into a payment plan. Each step, there's a model supporting that decision which helps a person to take the right action at the right time,” says Greg Allen, senior director of data science and product management at Ontario Systems.

Stanford University's 2021 AI Index Report is now available, and it goes into significant detail regarding Computer Vision, which is integral to the sorts of recognition tasks important in fraud detection and EOB processing.

Hindsight is 20/20, but it turns out that many medical practices and providers didn’t put into motion much digital preparation pre-pandemic, and that places them in a current payments predicament. This is according to Colin Mellon, senior vice president of Healthcare and Insurance Solutions at Fiserv. During a PYMNTS TV Trend Talk, Mellon noted that “the pandemic…

For healthcare providers, the decision of whether to handle revenue cycle management internally vs. outsourcing the function is not something be taken lightly. While there are pros and cons for each choice, the COVID-19 pandemic has complicated the decision even further. Medical Economics features an in-depth conversation with Anurag Mehta, president and co-founder of Omega Healthcare, about various impacts of COVID and how medical practices should adapt and rise to the challenge.

BusinessWire.com notes that what was once simply good, forward-looking policy and practice has now become essential in the age of COVID-19 -- "adoption of digital and accelerating the existing trend among providers and payers seeking to enhance operations, cut costs and better engage with stakeholders," according to a new report published today by Information Services Group (ISG) (Nasdaq: III), a leading global technology research and advisory firm (Customized versions of the report are available from NTT DATA, Persistent Systems and UST.)

Earlier this week Dr. Bob Wachter, the Chair of Medicine at UCSF and author of New York Times bestseller The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, shared a discussion with Dr. Muthu Alagappan, Medical Director at , to explore tested strategies for using AI and automation to get the most out of your EHR data and, as a result, thrive in the post-EHR era. A recording of the discussion can be viewed here.

UnitedHealth's information and technology-enabled health services subsidiary Optum -- a nonprofit physician group that operates 30 medical practices offering primary care, more than 50 specialties, plus imaging, lab, and pharmacy services to the Boston area -- is set to acquire Massachusetts-based Atrius Health, according to The Boston Globe and reported at HealthcareFinancenews.com. Meanwhile, Ensemble Health Partners announced that the United States Patent and Trademark Office has granted three additional patents to the company for its innovative automation technology -- that brings the total of Ensemble-approved patents to five.

Brandon Sim, the chief technology officer and chief operating officer at, a tech-powered healthcare management company, says the time to fully implement artificial intelligence and machine learning is now. From Healthcare Finance: "Especially because recent CMS regulations are going to force electronic health record companies to share their data in a more reasonably accessible fashion," Sim said. "Just the sheer amount of data that is being collected – the rise of alternative sources of data like remote patient monitoring and wearable devices – make it a very natural fit for using machine learning and AI methods in healthcare."

An excellent article by Giri Rajaiah, Executive Leader and Vice President for Global Healthcare and Life Sciences at DISYS, takes a look at how automation is absolutely essential to any healthcare organization that wants to remain relevant in today's -- and tomorrow's -- healthcare ecosystem. The ongoing COVID-19 pandemic has brought the immense pressure the U.S. healthcare system is under into sharp focus. Recent dynamics are compounded by the industry’s efforts to adopt newer ways of working and digitizing patient records, while implementing automation throughout their business processes to increase overall efficiency and productivity.

Are you ready for the wave of changes coming to healthcare? As is to be expected when a new administration takes over in Washington, the first 100 days of President Biden’s presidency are likely to bring a number of changes for employer-sponsored health and welfare plans, says Debra Hoffman and Stephanie B. Vasconcellos of Mayer Brown in their blog at Lexology.com.

Without a doubt, Artificial Intelligence, Deep Learning, Machine Learning, and other technologies are streamlining the revenue cycle management and healthcare payments industries in many different ways. Roni Boker, OrboGraph product manager notes: "Market need still exists, and organizations are now having to move faster than ever with new work environments as a means to implement greater controls on their data and assist with compliance and resiliency."

We have receive a tremendous amount of positive feedback from our recent #OrboZone launch, with a countless number of clients, partners, and industry experts raving about their "experience." But what is #OrboZone? It's dynamic content that combines high-impact videos, visual galleries, energizing music, and entertaining activities for your WFH environment.

No one has to tell you the revenue cycle automation process is complex, and getting more so every year. That's why it'll come as no surprise that Healthcare Finance News is reporting that about 30% of health systems and hospitals are unable to manage their revenue cycle automation efforts without at least two vendors. The numbers were gathered via the Healthcare Financial Management Association's Pulse Survey program, fielded between May 19, 2020 and June 22, 2020 among 587 chief financial officers and revenue cycle leaders at various health systems.

Artificial intelligence is already playing a significant role in worldwide healthcare, but Michael Spencer, editor in chief at The Last Futurist, is here to assure you that we haven't seen anything yet: The complexity and rise of data in healthcare means that artificial intelligence will increasingly be applied within the field. Several types of AI are already being employed by payers and providers of care and life sciences companies. AI is also starting to be used in pharma drug combinations and exploratory combinations and will drive a new era of biotechnology.

With COVID-19 vaccines being administered across the globe, the healthcare payments industry -- like the world population in general -- is feeling cautiously optimistic as 2021 begins. 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" to accelerate the digital transformation for healthcare. Matt Hawkins, CEO of Waystar, provides predictions for healthcare payments in the new year in an article posted on Modern Healthcare.

We have seen the banking and payments industries recover from the challenges of the COVID-19 Pandemic with a resurgence of checks and sustained volumes of other payments. With this recovery, banks and financial institutions can now refocus on automation and fraud prevention projects which have been delayed while the economy recovers.

To say 2020 will long be remembered as a challenging year for the healthcare industry is almost comical in its understatement. The strain put on all levels of the system, from front-line care all the way through collection and revenue cycle, has been incredible. Then comes this news out of Virginia via Healthcare Finance News: Newport News, Virginia-based Riverside Health System is coming out of 2020 able to say that it had one of its most improved collection, performance and revenue cycle years to date.

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 physical location standpoint, the pandemic has also had an interesting effect when it comes to technology.

PatientEngagementHIT.com examines the growth of patients consumerism and its impact on the healthcare industry. "Consumerism in healthcare regularly tops the list of C-suite priorities, with most organizations knowing they need to adapt to new patient behaviors to survive in a competitive industry. Health IT developers, healthcare payers, and policymakers alike are also working to acclimate to a world where the patient is also the medical consumer."

With healthcare organizations seeing lower volumes of patients for routine and elective procedures, the industry is having to withstand massive losses. While healthcare revenue for each organization depends on many factors, the American Hospital Association (AHA) reports that hospital operating margins are still down 28% year-to-date compared to 2019.

As we noted in our Check & Fraud recap earlier this week, the ORBOIMPACT VIRTUAL CONFERENCE, our two-day online event -- which covered Healthcare Payments on Thursday, October 29, and Banking & Payments on Friday, October 30 -- was a huge success! Industry speakers coupled with OrboGraph experts focused on AI innovation and payment strategy helped drive strong attendance, while innovative polling encouraged attendee participation and interaction.

The healthcare market anticipated some turbulent times, speculating about what uncertain future was in store while the Coronavirus was "spinning up." For example, John Talaga, executive vice president and general manager, healthcare at Flywire, predicted that at least some of Flywire’s healthcare clients might face a 30 percent revenue shortfall this year. In a story at pymts.com, Mr Talaga was happy to admit he was a bit too pessimistic.

Group, and Studer Education, recently released research results that reveal how COVID-19 is shifting the priorities of Healthcare industry executives (you can download their study here without having to provide any information).

Hopefully you've already registered for the ORBOIMPACT VIRTUAL CONFERENCE scheduled for October 29th and 30th. If not, what are you waiting for? ORBOIMPACT will explore AI innovation in the fields of check payments, check fraud, and healthcare remittance automation. The event is FREE and is accepting a limited number of virtual attendees , so register today if you haven't already! Check out our star-studded lineup of speakers!

Artificial Intelligence has made waves in a stunning variety of businesses, and Healthcare Revenue Cycle Management is certainly no exception. Over the past year, we have covered many different angles in our Modernizing RCM with AI and our OrboNation Healthcare Blog, including:

More than ever before, the healthcare industry is forced to maintain spartan budgets -- even as an unprecedented pandemic puts stress on all aspects of the industry. In a HIMSS20 digital presentation, Mark Morsch, vice president of technology at Optum360, cited data indicating a huge hole in efficiency -- as much as $200 billion in administrative waste due to inefficient revenue cycle practices.

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 12:15 PM ET.  During the…

It’s a safe bet to say that making a … safe bet during an unprecedented pandemic is not the easiest thing in the world. All the same, Becker’s Health IT got 20 healthcare executives and leaders to commit to posterity one health IT industry prediction for the next five years, and the answers are interesting,…

In a little over a month, OrboGraph will host the ORBOIMPACT Virtual Conference: AI Innovation for Check Payments, Check Fraud, and Healthcare Remittance Automation.

Revenue Cycle of the Future...something we have heard on several occasions. But what does it actually look like? In a recent article, HealthLeaders highlights a roundtable discussion sponsored by our friends at Waystar, bringing together a group of leaders in revenue cycle management to gather their thoughts on what they believe is important for the revenue cycle of the future.

Alpha Health recently released results of a national survey designed to examine and assess the impact of COVID-19 on revenue cycle operations at health systems and hospitals across the U.S. The survey was fielded between May 19, 2020 and June 22, 2020 among 587 chief financial officers and revenue cycle leaders at hospitals and health systems across the United States. The survey has a confidence level of 95 percent with a margin of error of plus or minus 5 percent.

A common misconception, especially in revenue cycle management (RCM), is that automating processes by integrating technologies like Artificial Intelligence and Machine Learning technologies will replace employees and eliminate jobs. This perception can be traced all the way back to when machines replaced labor in many manufacturing jobs like the automotive industry and is continually being fueled by the media with the story lines such as AI-powered trucks will replace truck drivers.

Technology just keeps getting better and better, right? Not always. A recent survey of health IT leaders reveals that they are most often unhappy with their electronic health record (EHR) packages. Healthcare IT Today reports on a survey 108 healthcare leaders about their use of analytics platforms. It starts out with some fairly positive data: 90% of these organizations reported using the analytics in their EHRs.

The New Yorker Magazine takes a close look (via Clifford Marks, an emergency-medicine resident at the Icahn School of Medicine at Mount Sinai) at how primary care practices and physicians are taking it on the chin due to the effects of the Coronavirus pandemic.

To the layman, much of the language in the AI space can be mystifying, particularly in deep learning. Take for example one of the core elements; the node. A deep learning node is "a computational unit that has one or more weighted input connections, a transfer function that combines the inputs in some way, and an output connection. Nodes are then organized into layers to comprise a network."

A new podcast at PYMNTS.com features a conversation with Jennifer Barker, Managing Director and Head of Wholesale Payments Product Delivery at JPMorgan Chase & Co., on the topic of business resiliency in this unprecedented pandemic environment.

In an environment challenged by Coronavirus, the already significant problem of healthcare fraud is more harmful than ever. Blue Cross Blue Shield reports: The National Heath Care Anti-Fraud Association estimates conservatively that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation’s $2.26 trillion in health care spending.…

RevCycleIntelligence.com cites a Commonwealth Fund study that shows outpatient visits for more than 50,000 providers declined by nearly 60 percent in mid-March when COVID-19 began to take hold, and the volumes have remained low through mid-April. Stay-at-home orders, of course, had much to do with the sharp downturn. Similarly, hospital visits also saw a substantial…

Moving from “big data” to “wide data” Visualization of data through DataOps and technology Data Visualization benefits for the Revenue Cycle Management In the digital world, we are seeing tremendous growth and robustness of data being collected through various systems, particularly in healthcare. According to a recent press release from Gartner: By 2020, most data and…