A growing number of physicians are voicing concerns about the increasing role of artificial intelligence (AI) in health insurers’ prior authorization processes. The American Medical Association’s (AMA) latest 2024 AMA Prior Authorization Physician Survey highlights that many warn AI-driven prior authorization denials are exacerbating patient harm and physician burnout. The survey, which included 1,000 practicing […]
Medical coding and billing are critical components of the healthcare revenue cycle. They ensure that healthcare providers receive proper reimbursement for the services rendered. However, the ever-evolving regulatory landscape, shifting payer policies, and technological advancements present numerous Medical Coding & Billing Challenges. These challenges significantly impact the efficiency and accuracy of the revenue cycle. As […]
In healthcare, claim denials pose a significant challenge to a provider’s revenue cycle. Each year, over $4.5 trillion in claims are submitted to insurance carriers in the U.S. alone. Despite this volume, healthcare providers continue to see an alarming rise in denied claims. In 2022, 42% of respondents reported an increase in denials, but by […]
Accounts Receivable (AR) days directly impact cash flow and overall financial health. The longer a claim sits in AR, the more challenging it becomes to collect revenue, leading to cash flow disruptions, operational inefficiencies, and reduced profitability. Therefore, it’s crucial for businesses to actively work to reduce AR days and improve their financial performance. With […]
As the healthcare landscape continues to evolve at an unprecedented pace, 2025 is poised to be a landmark year for revenue cycle management (RCM). With regulatory changes, emerging technologies, and shifting patient expectations, healthcare providers and RCM professionals must stay ahead of the curve to optimize financial performance and patient care. In this newsletter, we […]
A well-managed A/R process ensures timely cash flow, reduces administrative burdens, and maintains the stability of a healthcare practice. However, many healthcare practices still struggle with outdated, manual A/R management processes that can lead to inefficiencies, errors, and delayed payments. In recent years, Revenue Cycle Management (RCM) automation has emerged as a game-changer in addressing […]
In the ever-evolving field of medical billing, denied claims remain a significant obstacle for healthcare providers. Studies reveal that over 10% of claims face initial rejection by insurers, leading to revenue losses, administrative strain, and frustration for all stakeholders. To mitigate these challenges and ensure financial stability, an effective denial management process is essential. However, […]
However, AI in Revenue Cycle Management is emerging as a transformative solution. By automating repetitive tasks, improving accuracy, and providing actionable insights, AI is helping healthcare organizations streamline their processes and tackle these challenges more effectively. Revenue Cycle Management (RCM) is a cornerstone of healthcare operations, yet the growing complexity of today’s healthcare landscape poses […]
2025 promises to bring transformative changes to Revenue Cycle Management (RCM) in an ever-evolving healthcare landscape. To navigate financial complexities and enhance patient satisfaction, healthcare providers must stay on top of emerging 2025 Revenue Cycle Management trends as they emphasize efficiency, transparency, and patient-centered care. In this newsletter, we explore key RCM trends that will […]
Medical coding denials are a common challenge for healthcare providers and revenue cycle management (RCM) teams. They can disrupt cash flow, delay reimbursements, and increase administrative workloads. Avoiding these denials requires a proactive approach that addresses their root causes, ensures compliance with regulations, and fosters a culture of continuous improvement. In this blog, we’ll explore […]










