Financial assistance is moving from discretionary policy to regulated infrastructure. For health systems, that shift has significant operational and financial implications.

The post Financial Assistance Reform Is Reshaping Revenue Cycle Strategy appeared first on MedCity News.

When revenue cycle partners wait to be asked, or rely on “tell us what you need” as a default, they miss critical opportunities to deliver meaningful performance, support their client organizations, and ultimately serve patients better. In today’s healthcare environment, partnership requires anticipation, not reaction.

The post Stop Waiting to Be Asked: What Operators Really Need From Their Revenue Cycle Partners appeared first on MedCity News.

As AI-enabled coding increasingly adjudicates and reimburses claims on the first pass, often at higher levels, payers face a growing challenge: traditional cost-containment mechanisms are unable to keep pace.  

The post AI-Driven Coding is Driving Costs Up.  How Can Payers Adapt? appeared first on MedCity News.

Billing frustration isn’t just a provider problem; it’s a patient problem too.
Every delayed claim, every error, every confusing denial ultimately affects the person receiving care. Now AI can reduce that friction.

The post The $25.7B Healthcare Problem AI Is Finally Solving appeared first on MedCity News.

It doesn’t have to be this way. For the medical groups that lay the right foundation for patient collections, January is simply business as usual. Here are four ways to get ahead of the inevitable deductible reset.

The post Is Your Medical Group Ready for the January Cash Flow Crisis? appeared first on MedCity News.

At a time when people are questioning not just their bills but the institutions that send them, trust is the currency that matters most.

The post ‘Deductible Season’ Dilemma: Do Patients Really Need to Pay Those Past Due Bills? appeared first on MedCity News.

Ultimately, these strategies prepare clinics to refocus on their primary mission. The goal is to remove the formulaic work through automation and logic, freeing clinicians to perform the high-value clinical work they were trained to do.

The post Is Your Cardiac Clinic Ready for Reimbursement Cuts? Four Ways to Fortify Revenue appeared first on MedCity News.

A federal judge in Texas recently ruled on medical debt reporting — here’s what the ruling means for providers and for the millions of Americans who currently have or might one day have medical debt.

The post The Truth About Medical Debt and Credit Reporting: Three Things To Know appeared first on MedCity News.

[Sponsored] In today’s healthcare landscape, your choice of medical billing partner directly impacts your bottom line. What are the best medical billing outsourcing companies, and which one is right for you?

The post The Definitive Guide to Medical Billing Outsourcing: 5 Top Companies appeared first on MedCity News.

Efficient payment processing plays a central role in the success of healthcare practices, shaping everything from staff productivity and cash flow to patient satisfaction.

The post Is Your Practice’s Payment System Holding You Back? Ask These 3 Key Questions appeared first on MedCity News.

By reimagining the payment experience through transparency, flexibility, and technology, providers can drive better outcomes for both their bottom line and the patients they serve.

The post Improving Patient Payment Collections: Strategies for Success appeared first on MedCity News.

As an industry, we can and must do more. To be truly actionable, prices must be easily accessible, understandable, and patients need to be actively engaged to act on that information.

The post Healthcare Price Transparency is More Than Showing a Price Tag appeared first on MedCity News.

[Sponsored] Medical billing is a tedious administrative task, but outsourcing it may be the key to increased revenue. Explore the top medical billing outsourcing companies and the benefits of partnering with one.

The post The 5 Best Medical Billing Outsourcing Companies appeared first on MedCity News.

Simplifying payments isn’t just about transactions; it’s about building better relationships and ensuring financial health through protection, payment choice, scale, and integration. 

The post Payments Simplified: The 4 Key Features of Modern Healthcare Payment Platforms appeared first on MedCity News.

[Sponsored] Transitioning to PDPM models significantly shifted the healthcare industry. By replacing the RUG system, healthcare providers cut waste and more accurately reflect the care each patient received.

The post How PDPM Optimization Improves Facility Financial Performance appeared first on MedCity News.

The operational benefits of automated eligibility and payment workflows are clear, but its impact on people — both patients and staff — may be even more profound. 

The post Automating Insurance Verification: A Game-Changer for Pre-Visit Payment Collection appeared first on MedCity News.

With these tools, therapists can reclaim their time, focus on their patients, and deliver the high-quality care that every individual deserves — all while maintaining the financial stability to thrive in their practices. 

The post Therapists vs. Insurance: How AI Could End the Battle Over Mental Health Care appeared first on MedCity News.

Despite the evidence of their positive impact, pharmacists today lack the ability to reliably bill for clinical services as healthcare providers. It is important that payers provision pharmacists, include them in networks, and enable reimbursement through traditional billing models.

The post Pharmacists Embrace Provider Status in Healthcare, but Hurdles Remain appeared first on MedCity News.

Cedar recently launched a new set of features to bring the disconnected ecosystem of healthcare entities together and make billing easier to understand for patients. Pittsburgh-based payer Highmark Health and its health system, Allegheny Health Network, are the first customers to implement the product, which Cedar dubbed its “payer intelligence layer.”

The post Highmark, Allegheny Health Network Adopt Cedar’s New Tech to Alleviate Billing Confusion appeared first on MedCity News.

By improving billing and payment systems, healthcare providers can help ease what is a common, anxiety-inducing burden for many patients.

The post Why it’s time for hospitals to modernize their payment systems appeared first on MedCity News.

We’re past the point of technology being a Band-Aid to get practices through a pandemic. Investing in the right digital tools can help practices attract new business, get them paid faster and provide better patient care.

The post What’s next in healthcare consumerism: Digital management solutions benefit patients and providers appeared first on MedCity News.

The revenue cycle is incredibly complex due to shifting payer requirements, continuous regulatory compliance and coding updates, and emerging and evolving payment models. That complexity increases the administrative burden and drives up cost for providers.

The post How next-generation automation technology can improve healthcare revenue management appeared first on MedCity News.

The companies will build their claims processing platform on Google Cloud’s infrastructure, leveraging artificial intelligence and machine learning capabilities. The goal of the collaboration is to improve patient and provider experience and reduce spending on administrative processes.

The post Blue Shield of California, Google Cloud to develop real-time claims processing platform appeared first on MedCity News.

The lawsuit alleges that UPMC and the chair of its cardiothoracic surgery department knowing submitted false claims for concurrent surgeries that violated regulations. But, according to UPMC, there is no regulation that prohibits overlapping surgeries or billing for them.

The post Feds slap UPMC, cardiothoracic surgery chair with billing fraud suit appeared first on MedCity News.

Amazon has announced its first customer for its Amazon Care telehealth business aimed at employers. While who the customer is not particularly notable, Amazon’s billing structure is – the ecommerce behemoth is moving away from the usual per-member per-month payment structure that many vendors still use.

The post Amazon shuns per-employee fees with new telehealth business  appeared first on MedCity News.

Centene has rebutted the accusations made in a sealed lawsuit filed by the Ohio attorney general that accused the insurer of over-billing the state’s Medicaid department. The lawsuit is based on a misunderstanding of how Medicaid billing operates and should be unsealed, Centene said.

The post Centene refutes Ohio AG’s lawsuit, says it reflects misunderstanding of Medicaid billing appeared first on MedCity News.

Medical payments platform Inbox Health raised $15 million in series A funding. The company works with third-party billing companies to better communicate with patients and make bills clearer. 

The post Billing software startup Inbox Health raises $15M  appeared first on MedCity News.

A new survey from healthcare revenue cycle firm Waystar shows that most patients find their medical bills confusing and delay payment because of financial constraints. But there are steps hospitals can take to improve the billing experience for patients.

The post Simpler bills, more payment options can improve hospital billing experience appeared first on MedCity News.

Change Healthcare, a Nashville-based company that makes billing and analytics software, is rolling a new software that allows patients to order healthcare services in an ecommerce-like setting. The software allows patients to book, schedule and pay for healthcare services in advance.

The post Change Healthcare makes ecommerce software for healthcare providers appeared first on MedCity News.

Rural hospitals face a battle on two fronts with the Covid-19 pandemic. Many have invested funds to staff up or bring in additional beds to prepare for the pandemic. On top of that, cancelled procedures have delivered a blow to their bottom line.

The post For rural hospitals, financial shortfalls as challenging as Covid-19 appeared first on MedCity News.