Revenue Cycle Management

The healthcare sector is experiencing significant change because consumers now demand personalized services that operate on-demand across all industries. Subscription-based healthcare systems known as membership medicine present growing challenges to traditional fee-for-service models which suffer from unpredictable costs along with complex billing systems and transactional care approaches. Subscription-based healthcare functions similarly to Netflix or Spotify …

The Rise of Subscription-Based Healthcare Billing: Is Membership Medicine the Future? Read More »

The medical billing process undergoes transformation through artificial intelligence (AI) which accelerates operations and reduces errors while increasing efficiency. AI automation enables healthcare providers to optimize claims processing operations along with reducing their administrative tasks while enhancing revenue cycle management (RCM). The adoption of AI brings numerous benefits but also creates new compliance challenges for …

AI & Medical Billing Compliance: Ensuring Accuracy & Regulatory Adherence Read More »

Cybercriminals target the healthcare industry because it processes enormous quantities of sensitive patient information and financial data every day. As healthcare services become more digitalized cyber threats threaten billing and payment systems which results in financial losses operational disruptions and violations of patient confidentiality. The use of electronic health records (EHRs), revenue cycle management (RCM) …

How Cybersecurity Threats are Affecting Healthcare Billing and Payments Read More »

The No Surprises Act establishes essential legislative measures to shield patients from getting unexpected medical bills from out-of-network providers. Beginning January 1, 2022, the law prevents balance billing for emergency services along with select non-emergency procedures performed in-network. This law represents a huge victory for patients but brings substantial changes to revenue cycle management (RCM) …

No Surprises Act: How It’s Reshaping Healthcare Billing & Reimbursement Read More »

Any healthcare organization depends on Revenue Cycle Management (RCM) as its financial backbone. This system monitors and controls the full financial path of a patient which includes appointment scheduling and insurance verification before proceeding to billing and collecting final payments. Effective management of RCM systems delivers consistent cash flow and reduces claim denials to enhance …

RCM and Interoperability: Achieving Seamless Data Exchange Across Systems Read More »

The healthcare sector undergoes a digital revolution with revenue cycle management (RCM) leading this transformation. Traditional RCM processes face operational inefficiencies and administrative challenges that result in delayed reimbursements and financial losses. Generative AI is transforming healthcare billing and coding systems as well as claims and financial forecasting operations to achieve enhanced precision and operational …

How Generative AI is Reshaping Revenue Cycle Management in Healthcare Read More »

The healthcare sector experiences fast-paced digital evolution which alters provider-patient interactions. The digital transformation in healthcare has brought a major breakthrough with the introduction of the “Digital Front Door” which uses technology to improve patient interaction while making care access more efficient and updating billing and payment systems. The conventional approaches to patient payments generate …

The Digital Front Door: Transforming Patient Payments & Revenue Cycle Management Read More »

Patient payment behaviors in healthcare finance reflect the influence of multiple psychological and economic elements. Healthcare institutions improve collections through strict rules and monetary penalties but these methods overlook the fundamental motivations and psychological biases which determine patient payment behavior.  The research field of behavioral economics examines how psychological and social elements affect financial choices …

How Behavioral Economics Can Drive Better Patient Payment Outcomes? Read More »

The established healthcare system is now being transformed into retail healthcare by offering consumer-friendly medical services that are easily approachable and convenient. Major retailers, such as Walmart, CVS, and Walgreens, integrate medical services into their business models for direct engagement with patients which give access to immediate and affordable medical care. The change to retail …

The Rise of Retail Healthcare: Transforming RCM for a Consumer-Driven Model Read More »

The healthcare industry is abandoning fee-for-service (FFS) models in favor of value-based reimbursement (VBR). The transition targets better patient outcomes together with improved care quality while aiming to cut total healthcare expenses. To succeed in a value-based reimbursement setting, healthcare providers must adjust their operations to new measurement standards and payment methods. Healthcare organisations can …

A Step-by-Step Guide to Preparing for Value-Based Reimbursement Models Read More »