Payers Brace for Speedier Prior Auth Approvals—What's Next?
Explore how new trends in prior authorization are reshaping payer strategies and impacting healthcare practitioners in this insightful RCM article.
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
Payers face faster prior authorization approvals under CMS proposal - TechTarget
Payers face faster prior authorization approvals under CMS…
Price Transparency Lags for Vulnerable Patients—A Costly Oversight
Explore how price transparency gaps impact vulnerable patients, leading to financial strain and access issues in healthcare. A call for urgent reform.
More intelligence
Court Ruling Undermines Protections in No Surprises Act Disputes
Explore the recent court ruling impacting the No Surprises Act and its implications for patient protections in revenue cycle management disputes.
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.
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.