Stedi Launches ChatGPT App for Eligibility Checks — What RCM Teams Need to Know
The first approved ChatGPT app for patient insurance eligibility verification is live. No API key, no custom integration — connect in minutes. Here's what it means for front-desk and RCM workflows.
95% of SNF Prior Auth Denials Overturned — Impact on RCM Processes
Medicare Advantage Organizations reversed 95% of SNF prior auth denials, impacting RCM processes. Discover how this affects billing teams and workflows.
MA Insurers Deny Prior Auth Requests 20% Higher — Impact on RCM Teams
Massachusetts insurers deny prior auth requests 20% more frequently. RCM teams must adapt strategies to mitigate the impact on reimbursement and workflows.
Humana Will Slash Prior Auth for Medicare Advantage by 2026 — RCM Impact
Humana plans to reduce prior auth for Medicare Advantage by 2026. RCM teams will learn how this impacts workflow and denial rates.
Dozens of Insurers Cut Back on Prior Authorization — Impact on RCM Teams
Insurers are reducing prior authorizations, impacting RCM teams. Discover how these changes can streamline workflows and improve denial rates in your practice.
Med-Metrix Acquires CanAide — The Front-End RCM Land Grab Is Accelerating
Med-Metrix is acquiring CanAide to bolt Medicaid eligibility and enrollment onto its back-end RCM platform. PE-backed operators are sprinting upstream — here's what that means for health system procurement teams.
House Panel Votes to End WISeR Prior Auth Pilot — What It Means for RCM Teams
House panel votes unanimously to end the Medicare WISeR prior auth pilot. RCM teams will gain insight into its implications for billing workflows and compliance.
Black Book's 49-Category RCM Rankings Are Out — Here's What the Data Actually Tells You
Black Book ranked top vendors across 49 RCM categories based on 1,300+ provider surveys. What 78% said about payer friction, 74% about denial prevention, and 63% about AI auditability matters more than the vendor list.
CereVasc Raises $85M for AI-Driven eShunt System — Impact on RCM Teams
CereVasc's $85M funding will enhance its eShunt system. RCM teams must understand the financial implications and workflow adjustments ahead.
Wisdom Raises $28M to Enhance Dental Revenue Cycle Management Solutions
Wisdom raises $28M to enhance dental revenue cycle management solutions, promising RCM teams insights on product innovation and growth strategies.
British AI Clinical Workforce Platform TERN Group Raises €20M
TERN Group raises €20 million to address the healthcare workforce shortage. What AI-driven staffing means for RCM teams managing labor costs and productivity.
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.
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.
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.
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.
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.
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.
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.
Rivet Health Vendor Deep Dive: The Complete RCM Platform Review (2026)
Rivet Health offers a comprehensive revenue cycle management platform with a strong emphasis on AI-powered denial management and contract optimi
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
Rivet Health: The Fee Schedule and Patient Estimate Platform for Independent Practices
Rivet Health helps independent practices build accurate fee schedules and patient cost estimates. Here is where it delivers and where it hits its limits.
Thoreau Group Nears $12B Acquisition of Ensemble Health Partners
Matt Holt's Apollo-backed Thoreau Group is in advanced talks to acquire Ensemble Health Partners at a $12B valuation — one of the largest PE-backed healthcare services deals in recent…
More intelligence
MA Insurers Deny Prior Auth Requests 20% Higher — Impact on RCM Teams
Massachusetts insurers deny prior auth requests 20% more frequently. RCM teams must adapt strategies to mitigate the impact on reimbursement and workflows.
Prior Authorization Denials Surge — What It Means for RCM Teams
Prior authorization denials have surged by ~25%, impacting RCM teams. Discover actionable insights to navigate this growing challenge effectively.
FinThrive Launches AI Denials Prevention Manager — Stop the Denial Before It Happens
FinThrive's new Denials Prevention Manager uses AI trained on billions of claims to flag high-risk claims before submission. Up to 85% of denials are avoidable — and the industry has spent…