How Far AI Has Come in Revenue Cycle Management
Not long ago, the conversations about AI in healthcare were largely theory-based and the majority debated its potential. Many prototypes were showcased with the promise to eradicate the burden of denials, documentation errors, and coding inaccuracies. Well, those prototypes led to an actual, fully operational AI workflow for the healthcare revenue cycle. The numbers it […]
When Should You Sign an Assignment of Benefits Form?
There can be confusion regarding billing in healthcare for both the provider and the patient. A significant part of this process is the assignment of benefit (AOB) form, which determines how an insurer will pay a provider and how soon they will get paid for the services rendered. Many healthcare organisations include the use of […]
Point of Care CNA in Nursing Homes: Everything Providers Need to Know
The term point of care in nursing homes and skilled nursing facilities is more than just a charting technique. It is a workflow that enables CNAs to record resident care at the bedside or right after the care is provided rather than at the end of a shift. This real time strategy offers enhanced accuracy, […]
CMS Launched a Health Tech Ecosystem, Here is What it Means
America’s healthcare system had a technology centralization issue that policies alone were not able to fix. Fifteen years of federal regulation have produced more and more requirements regarding compliance but not a single step toward a connected system. Providers struggle to this day to access the patient records across settings and to solve it, CMS […]
How to Protect Your Modifier 25 Claim From Downcoding
Modifier 25 holds significance in medical coding as it tells the payer that a separately identifiable evaluation and management service was performed on the same day as the procedure. The very reason for its existence is to bill in cases where the patient arrives with more than a single problem. However, downcoding happens as the […]
AI Scribe for Mental Health- Automating Clinical Documentation
Mental health professionals face a heavy administrative burden, often spending up to one-third of their time on paperwork. Clinicians typically spend 35% of their day on documentation, which contributes to high burnout rates, with around 50% report moderate-to-severe burnout. Detailed, compliant notes are essential for continuity of care and proper billing, but they also consume […]
How to Choose the Right Claims Rules Engine for Your Healthcare Practice
Did you know claims denials cost U.S. healthcare providers an estimated amount of $262 billion annually? But you can avoid it with a right claims rule engine (CRE). It will catch errors before the claim leaves your practice. This guide will explain everything you need to know before selecting the right claims rules engine based […]
How Pediatric Scribe Improves Documentation Accuracy, Provider Efficiency and Patient Experience?
A significant portion of professional life of pediatrics is spent in scribing. Scribing has become one of the most time consuming job for pediatricians. Research shows that physicians spend 2 hours on scribing every day for one hour of patient care. In pediatrics this challenge is even greater. Visits include children of different age groups. […]
Agentic AI Comes to Healthcare Operations
What “AI Agents” Mean for Coding, Documentation, and RCM Healthcare operations are hitting a breaking point this year. The Healthcare Financial Management Association has reported that initial claim denial rates climbed to nearly to 12% and denials are occurring within seconds because payers have become more advanced in their use of AI. But there is […]
Implementing Predictive Analytics in Healthcare to Improve Care and Outcomes
The future of patient care is predictive analytics in healthcare, which allows healthcare providers to foresee potential health risks and patient needs and meet them before these issues develop. Due to the use of artificial intelligence and machine learning on large amounts of electronic health data, hospitals can predict complications or readmission risks before they […]