management Archives | Health Fitness

The Growing Cost of Medical Bill Collection: How Healthcare Organizations Are Using New AI and Clinical Insights to Improve the Revenue Cycle Management Experience

As more hospitals and medical practices assess AI applications to improve medical bill collection and revenue cycle management more broadly, it’s a good opportunity to discuss what healthcare organizations see as the ROI for revenue cycle management. That was one of the topics of a webinar sponsored by Smarter Technologies. The conversation with Smarter Technologies…

MedCity Pivot Podcast: A Flexible Approach to Pharmacy Benefits Management

Admin2 months ago026 mins

Large pharmacy benefit managers have come under scrutiny for their opaque business practices so much so that the term PBM has become mainstream. PBMs are routinely blamed for driving up costs of prescription drugs and have been regularly mentioned in the mentioned in the corridors of Congress as an industry needing reform. The top 3…

5 revenue cycle management predictions for 2026

Admin2 months ago06 mins

At A Glance Revenue cycle management (RCM) teams are facing a year of major change, with new regulations, tighter margins and the adoption of artificial intelligence (AI) increasing the pressure on workflows. This article outlines Experian Health’s five RCM predictions for 2026, along with tools to consider when building a resilient revenue cycle. Key takeaways:…

What is denial management in healthcare?

Admin3 months ago07 mins

At A Glance Denial management is the process of addressing why healthcare claims are rejected or denied, instead of resolving them after they occur. This article explores denial management strategies, why outdated processes fail and how AI-driven solutions can help reduce denials and streamline workflows. Key takeaways: Understanding why a claim is denied helps providers…

Revenue cycle management (RCM): A complete guide

Admin3 months ago012 mins

Key takeaways: Efficient revenue cycle management is crucial to ensuring efficient hospital operations and building financial stability. RCM technology solutions allow healthcare organizations to increase cash flow and improve operational efficiency across the entire revenue cycle. Revenue cycle management tools from Experian Health utilize data-driven insights, automation and AI to optimize revenue cycles, while supporting…

Reimagining patient access: AI at the epicenter of coordinated benefits management

Admin3 months ago06 mins

Healthcare claims denials are on the rise, despite more than a decade of industry-wide technological advances aimed at improving claims management processes. However, in recent years, the introduction of artificial intelligence (AI) into the healthcare ecosystem has begun transforming how healthcare organizations manage patient access — and the entire revenue cycle. This article summarizes a…

Q&A: How AI innovation is transforming healthcare revenue cycle management

Admin4 months ago010 mins

Healthcare organizations are facing a perfect storm: rising claim denials, evolving payer rules, and patients expecting providers to reduce error rates that impact patient billing accuracy. Artificial intelligence (AI) has raised the stakes, causing revenue cycle leaders to feel the pressure to modernize quickly. According to Experian Health’s State of Claims 2025 survey, 73% of…

Leveraging artificial intelligence for claims management

Admin4 months ago06 mins

Key takeaways: Manual work and disconnected claims management systems are often error-prone, resulting in delayed and denied claims. Technology, like automation and AI, can help healthcare organizations predict and prevent potential claims issues before submission. Implementing AI-powered claims management solutions should be a top priority for revenue cycle leaders. Healthcare claims denials are on the…

Claims management 101: A comprehensive guide to streamlining healthcare billing

Admin5 months ago07 mins

Key takeaways: Survey data shows that healthcare providers find it harder to secure reimbursement for their services. Automation, staff training and analytics are the keys to preventing denials, improving accuracy and streamlining every step of the claims process. Experian Health’s integrated claims management solutions are designed to close the claims gap and accelerate reimbursement. Claims…