Breaking
athenahealth 80+ AI features live — voice agents close prior auths in <1hr, Express Coding automates 51% of charges Kubera Health raises $6.5M to fix the contract-to-payment gap — 1 in 5 claims inaccurate, $1T admin burden Innovaccer acquires CaduceusHealth — 30 years of ambulatory RCM expertise, autonomous denial resolution OpenAI healthcare AI blueprint: silent on prior auth — what RCM needs to know Carlyle acquires Knack RCM + EqualizeRCM to build AI-native global RCM platform OpenEvidence and Tandem Partner to Streamline Prior Authorizations Develop Health Raises $14.3M Series A to Automate Prior Authorization Cigna updates telehealth policy - prior auth required for all virtual services after April 15 Medicare claims for telehealth must include modifier 95 effective March 15, 2026 Aetna requires prior auth for all inpatient stays starting April 1 - verify before scheduling UHC limits outpatient surgery coverage - pre-approval required for all procedures by March 20 BCBS outpatient PT copays increase to $50 effective April 1 - update patient estimates now Humana timely filing drops to 60 days for claims submitted after March 31 - audit your workflow Cigna updates telehealth policy - prior auth required for all virtual services after April 15 Medicare claims for telehealth must include modifier 95 effective March 15, 2026 Aetna requires prior auth for all inpatient stays starting April 1 - verify before scheduling UHC limits outpatient surgery coverage - pre-approval required for all procedures by March 20 BCBS outpatient PT copays increase to $50 effective April 1 - update patient estimates now Humana timely filing drops to 60 days for claims submitted after March 31 - audit your workflow
🟡 24H Urgent

Wisdom Raises $28M to Enhance AI in Dental Revenue Cycle Management

Wisdom raises $28M to enhance AI in dental revenue cycle management, offering RCM teams insights on innovation and growth trends in the sector.

🟢 48h · Deep Dive

InstaMed Review: Honest RCM Deep Dive — Unified Payments Platform (2026)

Independent InstaMed analysis — a unified payments platform, integration depth, and who it's actually best for. Built for RCM teams, not investors.

RevCycleAIJune 2, 2026
🟡 24H Urgent

Garner Health Raises $100M in Series E — Implications for RCM Teams

Garner Health's $100M Series E funding signals shifts in healthcare navigation. RCM teams will need to adapt strategies for improved billing workflows.

Modern HealthcareJune 2, 2026
🟡 24H Urgent

Trinity Health Reports $200M Operating Income — Implications for RCM Teams

Trinity Health's $200M operating income outpaces peers. Key implications for RCM teams and how to optimize billing strategies effectively.

Fierce HealthcareMay 28, 2026
🔴 Breaking · Prior Auth

Congressional Push to End Medicare AI Prior Auth — Implications for RCM

Congressional Democrats aim to end Medicare’s AI prior auth program, impacting RCM workflows. Discover what this means for billing directors and revenue cycle leaders.

STAT NewsMay 21, 2026
💰 Deals & Raises · Prior Auth

Cohere Health Raises $90M Series C to Scale Prior Auth AI Platform

Led by Temasek with $200M total raised. Cohere auto-approves 90% of the 12M+ prior auth requests it processes annually — and is now expanding into broader clinical decision-making.

RevCycleAI May 17, 2026 All Deals & Raises →
⚡ Strategy · AI Tools

The RCM Developer Problem Is Over

AI coding agents just closed the gap between knowing what to build and being able to build it. Here's what that means for revenue cycle teams that have been waiting on IT for years.

RevCycleAI May 7, 2026
🔴 Immediate · Regulatory

Prior Authorization is Breaking Trust—Time for a 21st Century Fix

Outdated prior authorization processes are undermining trust in healthcare. Here's what the CMS is saying and what it means for your revenue cycle.

CMS Newsroom (Direct) May 6, 2026 Policy lookup → Axlow ↗
🔴 Immediate · Industry

Carlyle Bets Big on AI-Native RCM: What the Knack + EqualizeRCM Deal Means for Your Practice

Carlyle acquires majority stakes in Knack RCM and EqualizeRCM to build an AI-native, global, multi-specialty RCM platform. When PE at this scale bets explicitly on AI-native delivery, the bar for every RCM vendor just moved.

Industry Analysis May 5, 2026 Policy lookup → Axlow ↗
🔴 Immediate

AI Enters the Fray: Can It Solve Our Denial and Underpayment Crisis?

Explore how AI can tackle denial and underpayment issues in revenue cycle management, offering innovative solutions for healthcare practitioners.

RCM Technology & AI (Google News) May 5, 2026 Policy lookup → Axlow ↗
🔴 Breaking · Technology

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.

GlobeNewswire / RevCycleAI Analysis April 1, 2026
⚡ Strategy

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.

RevCycleAI April 1, 2026
🔴 Regulatory · Admin Simplification

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.

CMS / RevCycleAI March 22, 2026 Policy lookup → Axlow ↗
🔍 Vendor Deep Dive - Week 9

Experian Health: The Credit Bureau's RCM Play - Data Moat, Patient Access, and What It Can't Do

Bureau-grade identity verification, credit-data propensity scoring, and Patient Access Curator AI. Best front-end platform for high-volume systems - but not end-to-end.

RevCycleAI March 31, 2026
🟡 24H Urgent

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.

Innobot Health March 17, 2026 Policy lookup → Axlow ↗
🔴 Immediate

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.

Claim Denials & Denial Management March 5, 2026 Policy lookup → Axlow ↗
🟢 Industry Signal · AI

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.

Fierce Healthcare March 11, 2026 5 min read
🔍 Vendor Deep Dive · Week 28 of 52

Zelis Vendor Deep Dive: The Complete RCM Platform Review (2026)

Zelis focuses on modernizing the healthcare financial experience by bridging gaps between payers, providers, and consumers. Despite its strengths, Zelis face

RevCycleAI Jun 4, 2026 All Deep Dives →
RevCycleAI Pro · $19/mo

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.

📋
Prior Auth Tracker50+ procedures × 6 payers
🔴
Denial Code Playbook60+ codes with appeal scripts
📊
RCM Funding Database16 deals tracked
🔐
UHC Prior Auth Playbook7 tactics, real denial data
Get Pro Access - $19/mo → See all resources first →

Also developing

🟡 24H Urgent

Ilant Health Raises $15M in Series A — Implications for RCM Teams

Ilant Health raised $15M in Series A funding. RCM teams will gain insights into how this impacts billing processes and vendor dynamics in healthcare.

🟢 48h · Zelis

Zelis: The Payment Integrity and Network Company Touching More Claims Than You Think

Zelis reprices hundreds of millions in claims annually. Here is how their network, payment integrity, and communications products intersect — and what…

More intelligence

1
🟢 48h

athenahealth's 80+ AI Features: What RCM Teams Need to Know

athenahealth just dropped 80+ AI features into athenaOne — including voice agents closing prior auths in under an hour, AI coding that automates 51% of charges, and a 30% lift in recovered…

2
🟢 48h · InstaMed

InstaMed Review: Honest RCM Deep Dive — Unified Payments Platform (2026)

Independent InstaMed analysis — a unified payments platform, integration depth, and who it's actually best for. Built for RCM teams, not investors.

3
🟢 48h · EDI / Clearinghouse

Stedi Drops the $500/Month Minimum — What It Means for RCM Teams and Vendors

Stedi just eliminated the $500 monthly minimum for production API access. Pay-as-you-go clearinghouse EDI is now a real option for RCM startups, small practices, and solo developers.