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Emerging Technologies in RCM: AI and ML in Denial Prevention

Revenue Cycle Management (RCM) plays a crucial role in the healthcare industry in ensuring the financial stability of healthcare providers. One of the most challenging aspects of RCM is the processing of medical insurance claims, ranging from simple to complex and unstructured documents that require manual processing and communication between ...Read More
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  • Blogs

The True Cost of Denials to Healthcare Providers

In the healthcare sector, claim denials have become a significant problem for healthcare providers. Benchmark studies show that the financial impact of medical claim denials has increased by 67% in the past year. On average, a health system faces 110,000 denials annually. The claims rejection rate has increased from 8% ...Read More
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How Risk Adjustment Can Benefit a Provider’s Bottom Line

As the healthcare industry continues to evolve rapidly, risk adjustment has become a crucial factor that directly affects the quality of care and the financial standing of healthcare providers. Understanding the intricacies of risk adjustment is essential now more than ever. As payment methods become more complex, healthcare providers must ...Read More
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Ensuring Quality and Compliance in Outsourced RCM

Every thriving healthcare organization recognizes revenue cycle management (RCM) as its financial backbone. Despite this, many healthcare institutions are grappling with financial challenges. With continually rising costs, margins have been under significant pressure, with labor costs per discharge surging by 37% from 2019 to March 2022. This intricate sequence of ...Read More
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Beyond ICD-10 and ICD-11: The Evolution of Medical Coding

The healthcare industry has undergone significant changes in recent years, with notable evolution in medical coding, advancing from ICD-10 to ICD-11. With the shift from ICD-10 to the more advanced ICD-11, healthcare professionals find themselves adapting to a wave of changes. This transition reflects healthcare systems' increasing complexity and reliance ...Read More
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