What You Should Know: - 100 percent of hospital and health system respondents stated that staffing shortages have significantly affected revenue cycle management (RCM) and patient engagement efforts, according to a new survey by Experian Health. - A significant 69 percent of the surveyed healthcare executives responsible for RCM staffing foresee ongoing challenges in the long term. Challenges Present Urgent Need for Solutions The findings highlight the urgent need for
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Understaffed RCM Payment Teams Need a New Way Forward
Last year, only 8% of healthcare executives said their RCM or billing departments were adequately staffed, and a stunning 48% said the employee shortage was “severe,” according to a survey cited in MedCityNews. RCM teams are the engine that allows the machinery of healthcare organizations to run. Without effective billing and payment processes that deliver positive patient financial experiences, everything grinds to a halt. These staffing woes can’t continue. The cascade of problems that
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Waystar Postpones U.S. IPO in Response to Market Turbulence
What You Should Know: - Waystar, a healthcare payments company, has decided to postpone its initial public offering (IPO) due to the ongoing market turmoil in the United States, according to a confidential source. Reuters first reports the company plans to revive its IPO efforts, but it is likely to wait until December at the earliest or possibly until 2024. - The decision to delay the IPO was made in response to the volatility in the broader market. Despite receiving positive
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First CPT Code for AI Prostate Cancer Imaging Issued for Avenda Health
What You Should Know: - Avenda Health's AI mapping tool for prostate cancer, Unfold AI™, has received significant recognition by obtaining a new Category III CPT code in the 2024 Current Procedural Terminology (CPT) code set, signifying its status as a cutting-edge medical technology. - The new Category III CPT code, X237T, outlines the tool's capabilities, describing it as a non-invasive prostate cancer estimation map that is derived from an augmented analysis of image-guided fusion
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Olive Shutters Business After Sale to Waystar and Humata Health
What You Should Know: - Healthcare automation company Olive today announced it will shut down its business after selling its Clearinghouse and Patient Access business units to Waystar and its Prior Authorization business unit to Humata Health. Olive sold off its utilization management solution and business unit to Availity and business intelligence solution to BurstIQ earlier this year. - Founded in 2012, Olive is a developer of an artificial intelligence workforce, automated
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Automation Fills Gaps Left by Revenue Cycle Talent Shortage
Healthcare providers are feeling the industry’s talent shortage in their administrative functions as well as clinical areas. One case in point: revenue cycle management. In a recent study, 63% of healthcare providers reported an inability to fill key revenue management roles. Reduced revenues and cash reserves are almost inevitable when providers don’t have sufficient staff to follow up on claims, manage appeals and help patients understand their financial responsibilities and
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Autonomous Coding Highly Trusted by Healthcare Finance Pros, But Not Well Understood
What You Should Know: - Autonomous coding enjoys a high level of trust among healthcare finance professionals who use or plan to use the technology, according to new survey from the Healthcare Financial Management Association (HFMA) on behalf of AGS Health. - The survey reveals 45 percent of healthcare financial professionals indicate autonomous coding often works well and 16 percent place their complete trust in it. However, despite its emergence as a powerful tool for streamlining and
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Abridge Raises $30M for Generative AI Scribe to Tackle Clinician Burnout
What You Should Know: - Abridge, a company leading the way in generative AI for healthcare raises $30M in Series B funding led by Spark Capital, along with several leading healthcare innovators, including Mayo Clinic, Kaiser Permanente Ventures, CVS Health Ventures, UC Investments, Lifepoint Health, SCAN Health Plan, and the American College of Cardiology. - Abridge’s generative AI scribe automatically converts a patient-clinician conversation into a structured clinical note draft in
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Why Avoiding Costly Coding Mistakes Is More Critical Than Ever
In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. His crime: performing unnecessary vein ablation procedures on patients, and using incorrect billing codes to receive larger reimbursements. He received $4.5 million in reimbursements from Medicare over a three-year period. Compared to this example, most instances of “upcoding” and “overcoding” are not as malevolent or expensive. But even an
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Health M&A: Financial Distress Driving Q3 Healthcare Deals
What You Should Know: - More than one-third of hospital and health system transactions announced in Q3 2023 involved a party that cited financial distress as a transaction driver, according to Kaufman Hall’s latest mergers and acquisitions (M&A) report. The reports reveal third quarter M&A activity remained high with 18 announced transactions resulting in $8.2B in total transacted revenue. - Kaufman Hall experts say transaction activity is regaining momentum as hospitals,
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