Brian E Denhart

Can generative AI revolutionize RCM? Generative AI has made impressive strides in healthcare, from diagnosing complex cases to aiding in drug research. However, its potential for transforming revenue cycle management is often overlooked. Where generative AI might be helpful? ✔️Generating appeals for claim denials ✔️Streamlining prior authorizations & documentation ✔️Data-powered decision making ✔️Strategic financial planning through predictive analytics However, there are areas where generative AI may fall short. ❗️Limitations of Generative AI: ❗️Understanding nuanced communication ❗️Dependence on data ❗️Tackling intricate claim denials While generative AI might not be an answer to all revenue cycle challenges, it holds promise in reducing administrative burdens and improving workflows. What do you think? Kenny Dewan Monika Roots, MD, FAPA Scott Penn #RevenueCycle #RevenueCycleChallenges #GenerativeAI #RCM #RevenueCycleManagement

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Are operational inefficiencies hindering your organization's progress towards it objectives? If you are among the EHR users seeking optimal functionality, while the EHR vendor may offer solid capabilities, it may not cover all of your needs. That's where Pivot Point Consulting steps in. We go beyond the basics of the EHR, meticulously analyzing its features and drawback, and tailor its functionality to seamlessly align with your organization's core objectives. Let us empower your organization to reach its goals and fulfill its mission effectively! Reach out today to let me know how we can support your mission! #eCW #athena #NextGen #Epic https://lnkd.in/gYhQSjkm

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The new CMS prior authorization rule plays a key role bringing in automation and efficiencies to the current manual processes. It is not just compliance but more than that. Thrilled to be a co-author of the article below, providing insights into what payers need to consider along their prior authorization journey. #citiustech #priorAuthorization #CMSRule

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Vaco got its start in managed services in 2012. With a focus on advising, designing, building, maintaining and operating functions—not just shipping tasks offshore (although we can do that, too)—Vaco tailors its approach to individual client requirements, whether onshore, nearshore or offshore, to enhance efficiency and maintain quality. How the engagement ultimately takes shape really depends on the organization and what the client needs. To read more about the variety of managed services Vaco provides, check out this article by Vaco Holdings Chief Revenue Officer Steve Kass. https://lnkd.in/eqtwV7C4 Staffing Industry Analysts | #managedservices | #outsourcing | #businessinnovation | #businessstrategy

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I am very much looking forward to presenting on data analytics and how this can help drive improvement for payment integrity with claim billing and payment.

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One of the many ways we make it a better world at Merative/Curam: Supporting the US Medicaid streamlining rule to meet current and future needs in health and human services. Explore our blog for guidance on navigating the evolution of benefits streamlining: https://bit.ly/3w0oMt4 #Medicaid #CHIP #Curam #StreamliningBenefits #HealthandHumanServices #CMSNewRule

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The decision to leave clinical practice is not an easy one for many. The big question is, those who left, what are they doing now? One thing you can do is Business Analysis, and that is what this article covers. Read here: https://zurl.co/0Mcq Share your comments.

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𝐓𝐡𝐢𝐬 𝐢𝐬 𝐬𝐨 𝐢𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐭𝐨 𝐭𝐡𝐞 𝐋𝐓𝐏𝐀𝐂 𝐜𝐨𝐦𝐦𝐮𝐧𝐢𝐭𝐲. But the ruling could also have broader implications for data privacy and particularly around the use case of analytics companies having broad access to patient health information. I can imagine that this might also have implications for LLM training data, as AI continues to march throughout the healthcare ecosystem. Real Time Medical Systems alleges that PointClickCare (PCC) is blocking its access to EHR data by using security ciphers. Real Time claims this is an anti-competitive move following PCC's expansion into post-acute analytics. A judge appears likely to block PCC's actions, emphasizing the need for data access to improve patient care as mandated by the 21st Century Cures Act. This may enhance interoperability, but there is a lot to consider. Thank you Brendan Keeler for bringing this important topic to light.

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Prior authorization improvements will be motivated by CMS mandated improvements and ONC information sharing requirements on providers and payers and there is no time to lose in improving the collaboration of providers and payers. Better collaboration among providers and payers can reduce unneeded denials and appeals resulting from inadequate and delayed sharing of payer requirements and provider documentation. Better information sharing earlier in patient episodes will also improve transitions in care, outcomes, and unneeded denials. Actual improvements sought by measuring approvals, denials, appeals beginning next year (to report in 2026) will only happen by motivation to collaborate more than comply. Patients depend on this today, no time to lose! https://lnkd.in/e4Z-jfPQ

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Really enjoyed your article Joe Procopio. Great clarification on the differences between #projectmanagement versus #productmanagement and how project management's main focus is failure avoidance. With this in mind, why do you think there are still so many failed #projects? #transformation #digitaltransformation https://lnkd.in/gksUB2s8

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Clinical data is flowing more freely to health plans, but vital financial data is not getting to providers. U.S. provider organizations need to understand how information asymmetry will impact them and what to do about it. Here is my latest. https://lnkd.in/gZ-jnTJB #informationasymmetry #interoperability #valuebasedcare #healthtechmagazine

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Time to share your thoughts with the ONC on health equity, modernizing public health delivery and tech, and real people having meaningful actionable access to their health data.

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🚨 🚨 The decision over cost to obtain medical records using FHIR API in #claimsmanagement and #litigationmangement is happening. 1. Seeking comment on threshold condition for Attorney requests. (P. 531) 2. Seeking comment on fees for TEFCA Sub participants. (P.561) 3. Info session July 17 (Not likely on fees for injury claims and litigation.)

Read on and align with these on point insights curated by the amazing Jennifer Rydd, RHIA, CRCR to ensure your Telehealth strategy is finely tuned. Follow Jennifer and our entire team of bright, seasoned RCM, Payer, Pay-vider and VBC professionals @ MedeAnalytics for more exceptional analytics and insights!

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