Wound Care RCM: Technology That Heals Financial Wounds
Wound Care RCM: Technology That Heals Financial Wounds Imagine a world where wound care billing strengthens, rather than weakens, a provider’s financial health. For years, providers in this specialty have been burdened with endless paperwork, coding errors, and unpredictable reimbursements — creating silent financial wounds that erode sustainability and compromise patient access. At the same […]
How Artificial Intelligence is Transforming Revenue Cycle Management in Healthcare
In today’s rapidly evolving healthcare landscape, hospitals and medical billing companies face growing pressure to improve efficiency, minimize errors, and enhance financial performance. One key driver of this transformation is artificial intelligence (AI). AI technologies are no longer futuristic concepts in healthcare. From clinical diagnosis to back-end billing processes, AI is steadily reshaping how healthcare […]
PAMA Delays Are Not Enough: Why Labs Need Permanent Reform
Since the Protecting Access to Medicare Act (PAMA) became law in 2014, the laboratory industry has faced nearly a decade of instability. While temporary delays to cuts and reporting requirements provide short-term relief, they do not address the deeper structural flaws that threaten access to diagnostic care and the long-term financial health of laboratories. […]
Artificial Wisdom vs Artificial Intelligence
In an era where healthcare technology evolves at lightning speed, relying solely on automation is no longer sufficient. Healthcare organizations need a more refined approach, one that seamlessly combines human judgment with the precision of algorithmic power. That is where artificial wisdom comes in. AI Enhances, but Human Expertise Guides Artificial Intelligence (AI) offers […]
Uncovering Revenue Loss: How Under-Coding Impacts Infusion Services
In today’s healthcare landscape, infusion services are essential for delivering life-saving therapies to patients with chronic illnesses, cancer, autoimmune conditions, and more. Despite the complexity of these treatments, many providers face a persistent and often overlooked threat to their financial performance: under-coding. Unlike over-coding, which can trigger audits and compliance risks, under-coding quietly erodes revenue, […]
Breaking the Cycle of Denials: How HealthRecon Connect Can Optimize Your Revenue Cycle
In the complex landscape of healthcare revenue cycle management, claim denials remain a significant and costly challenge. They disrupt cash flow, increase the administrative burden, and can ultimately impact a provider’s ability to deliver timely and high-quality care. Industry data indicates that denial rates typically range from 5% to 10%, with some organizations facing rates […]
AB 1041: California’s New Credentialing Rules Are Coming – Is Your Organization Ready?
California’s Assembly Bill 1041 (AB 1041) will soon transform provider credentialing requirements for health care service plans and insurers. Beginning January 1, 2026, health plans and insurers will be held to strict deadlines and new requirements. What’s Changing Under AB 1041, health care service plans and insurers must: Complete credentialing within 90 days – […]
Cigna’s New E/M Coding Policy Goes Live October 1 – Are You Ready?
Don’t wait until October. Now is the time to review your current E/M coding practices to ensure you’re prepared for Cigna’s changes. What You Need to Know Cigna’s R49 policy tightens reimbursement criteria for evaluation and management (E/M) services. While the changes officially take effect October 1, the impact could be felt immediately if […]
The Critical Role of Cybersecurity in Revenue Cycle Management
Safeguarding Financial Health in the Digital Healthcare Era In today’s digital-first healthcare landscape, healthcare organizations are more than just care providers. They are custodians of sensitive patient data. This information forms the backbone of two critical operations: Revenue Cycle Management (RCM) and Cybersecurity. These domains are deeply interconnected, and their synergy is essential for ensuring […]
Are Prior Authorizations Slowing Wound Care? Here’s What You Can Do About It
In wound care, timing is everything. Delayed treatment not only affects healing outcomes but directly impacts provider revenue. Yet in 2025, one of the biggest disruptors to timely wound management remains prior authorizations (PAs). While insurers argue that PAs encourage cost-effective care, the reality for providers is far more complex. Clinics and wound care centers […]