New & Notable
Waystar tackles $40B denials problem with new AI capability
As part of creating an autonomous revenue cycle, Waystar is now using AI to identify silent denials from post-payment adjustments.
CMS proposes Medicare payment rules for SNFs, 3 others
CMS is seeking to increase payments to skilled nursing facilities, hospices and inpatient rehabilitation and psychiatric facilities next year, while cracking down on hospice fraud.
Hospitals lost over $48B from claims denials, uncollected bills
Revenue leakage worsened for hospitals in 2025, as payers denied more claims and bad debt increased significantly, according to a new report.
Over 130 hospitals sue HHS over DSH payments
Hospitals in 16 states have sued the department, arguing a 2023 final rule underpays hospitals that treat a disproportionate number of low-income patients.
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CareCredit
We do something very simple at CareCredit: We help people get the care they want for themselves and their families.
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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CMS proposes Medicare payment rules for SNFs, 3 others
CMS is seeking to increase payments to skilled nursing facilities, hospices and inpatient rehabilitation and psychiatric facilities next year, while cracking down on hospice fraud.
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Hospitals lost over $48B from claims denials, uncollected bills
Revenue leakage worsened for hospitals in 2025, as payers denied more claims and bad debt increased significantly, according to a new report.
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Ensemble, Cohere partner on LLM for revenue cycle management
Ensemble said it will build a revenue cycle management-native LLM with the enterprise AI company to manage specific RCM workflows and payer rules.
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Adonis raises $40M to accelerate AI in revenue cycle
With users like Mount Sinai Health System, Adonis raised $40M in Series C funding to further drive the application of AI in its revenue cycle platform.
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AMA: Blended physician compensation model prevails
New data from the American Medical Association reveals major changes in physician compensation, with a blended model based on salary and productivity being most popular.
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CMS vows to ditch faxes for electronic claims attachments
A new final rule would establish standards for the electronic exchange of claim attachments for all HIPAA-covered entities by 2028.
Features
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The U.S. finally bent the healthcare cost curve, one economist says
Health economist David Cutler's new analysis shows a deceleration in U.S. healthcare spending as technology advancements make care cheaper.
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How AI scribes are shifting coding intensity, reimbursement
The proliferation of AI scribes for clinical documentation has started a shift in coding intensity, raising concerns about reimbursement and affordability.
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Agentic AI evolution begins to pave way for autonomous revenue cycle
A fully automated revenue cycle in which staff work hand-in-hand with AI is looming, but success will require a mature AI strategy.
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How NGHS balances revenue cycle AI adoption, ROI
Northeast Georgia Health System is accelerating AI adoption, especially in revenue cycle management, but leaders have learned to balance speed of innovation with ongoing ROI.