Prior Authorization Isn't Enough for Optimal Patient Outcomes
Explore why prior authorization alone falls short in achieving optimal patient outcomes and discover strategies to enhance care effectiveness.
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.
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.
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.
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.
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.
Also developing
$16M to Tackle a Growing Crisis in Insurance Denial Management
Explore how a $16M initiative aims to improve insurance denial management, enhancing revenue cycle efficiency and supporting healthcare providers.
Humana's 25% Growth Plan: Can They Keep Members From Churning?
Explore Humana's ambitious 25% growth plan and strategies to retain members amidst rising competition in the healthcare market. Insights for practitioners.
More intelligence
New Prior Auth Rules Could Burden RCM Pros Amidst Data Overhaul
Explore how new prior authorization rules may challenge RCM professionals as they navigate a complex data overhaul in today's healthcare landscape.
Fathom: The AI Medical Coding Platform Automating Charge Capture at Scale
Fathom uses deep learning to read clinical notes and automatically generate accurate medical codes — targeting the labor-intensive coding bottleneck that…
AI in Nursing: Balancing Efficiency with Human Oversight
Explore how AI enhances nursing efficiency while ensuring vital human oversight, striking a balance between technology and compassionate care in healthcare settings.