Prior Auth Reform: A Step Towards Trust or Just Another Band-Aid?
Explore the nuances of prior authorization reform in RCM. Is it a genuine step towards trust or merely a temporary fix? Practitioner insights inside.
Patients Are Using AI to Fight Your Bills. Here's What That Means for RCM.
The NYT reported patients are using Claude and ChatGPT to dispute hospital bills at scale. The AHA has already alerted members. Here's what billing teams need to do now.
Ensemble + Cohere Are Building an RCM-Native LLM. Here's Why That's Different.
Not a GPT wrapper. Not prompt engineering. A fine-tuned model trained on real RCM operational data from 30+ health systems. The AI RCM arms race just shifted from model access to domain-specific training data.
The RCM intelligence toolkit that pays for itself on one recovered claim.
Built by people who've worked the denials, coded the claims, and sat across from underwriters. Not theory - operational tools for the revenue cycle floor.
Smarter Technologies Launches SmarterUtilization - What It Means for RCM Teams
AI-powered inpatient utilization management is now part of Smarter Technologies' platform. Here's what it does, why UM is the new battleground, and what to validate before signing.
AI Is Coming for Your Revenue Cycle. Here's What That Actually Means.
EY's new report on AI-driven RCM gets the framing right. But the transformation they're describing doesn't require a consulting engagement - it requires targeted automation against specific denial codes.
CMS Phases Out Fax Machines - What the Claims Attachments Rule Actually Means for RCM
$782 million in annual savings. Electronic claims attachments mandated by 2028. The fax era is officially ending.
Banjo Health: The Prior Auth Intelligence Platform RCM Leaders Should Know About
Real-time payor policy aggregation, approval prediction scoring, and a 7 Powers analysis. What RCM leaders need to know before signing.
Is Your EHR Holding Back RCM Automation's True Potential?
Explore how your EHR system may be limiting RCM automation and discover strategies to unlock its full potential for improved revenue cycle management.
Denial Rates Surge as Prior Auth Rejections Plummet-What's Next?
The denial rate is climbing while prior auth rejection counts drop. What's driving the divergence and what it means for your AR.
What Fierce Healthcare's Fierce 15 of 2026 Signals for Revenue Cycle
The 2026 class is dominated by operational AI - not diagnostics, not therapeutics. Escher Health, Hyro, and Artisight have direct RCM implications. Here's what to watch.
Turquoise Health Raises $40M to Turn Healthcare Contracts Into Live Infrastructure
$40M Series C led by Oak HC/FT. Turquoise is evolving from MRF data vendor to full contract intelligence platform - and the RCM implications are significant.
Also developing
Unlocking Revenue: The Hidden Costs of Denial Management in Healthcare
Discover the hidden costs of denial management in healthcare and learn strategies to optimize revenue and improve financial outcomes for your practice.
Will New Prior Auth Rules Drive Payers to Embrace AI Solutions?
Explore how new prior authorization rules may push payers to adopt AI solutions, enhancing efficiency and improving patient care in healthcare practices.
More intelligence
AI Can Ease Nursing Workloads, But Human Insight Is Key
Discover how AI can streamline nursing tasks while emphasizing the importance of human insight for optimal patient care and decision-making.
Will New Interoperability Rules Finally Tame Prior Auth Chaos?
Explore how new interoperability rules may transform prior authorization challenges in healthcare, enhancing efficiency and patient care for practitioners.
HaloMD's Legal Win Raises Questions About Out-of-Network Billing Practices
Explore HaloMD's recent legal victory and its implications for out-of-network billing practices, shedding light on challenges for healthcare providers.