Upcoming Changes in DME Billing for Chronic Disease Management
Durable Medical Equipment (DME) plays a vital role in managing chronic diseases by providing essential medical devices that help patients monitor and maintain their health. As healthcare policies continue to evolve, the Centers for Medicare & Medicaid Services (CMS) has introduced significant revisions to DME billing procedures for 2025. These updates aim to align healthcare [...]
The U.S. Revenue Cycle Management Market Surges to $272.78 Billion by 2030, Multi-Billion Opportunity Projected in the Coming Years.
The U.S. Revenue Cycle Management (RCM) market is experiencing robust growth, propelled by the escalating complexities in healthcare billing, continuously evolving regulatory requirements, and the growing prevalence of high-deductible health plans. Within this market, the post-cycle segment is emerging as a high-growth area, driven by rising insurance claim denials and persistent cash flow challenges faced [...]
Three Key Trends Shaping Revenue Cycle Management in 2025
Revenue cycle leaders are navigating an increasingly complex and unpredictable landscape. With a new federal administration appointing unconventional leaders to the Health and Human Services Department and the Centers for Medicare & Medicaid Services, questions surrounding the future of government reimbursement policies are mounting. Meanwhile, payers continue to pressure provider organizations, driving them toward lower [...]
Managing Out-of-Network Billing in ASCs: Best Practices
Ambulatory Surgery Centers (ASCs) play a vital role in providing high-quality, cost-effective surgical care outside traditional hospital settings. However, one of the most significant financial challenges ASCs face is managing out-of-network (OON) billing. Compared to in-network claims, OON billing involves more complex processes, lower reimbursement rates, and a higher likelihood of claim denials. To address [...]
Top Revenue Cycle Management Trends to Watch For in 2025
The healthcare industry has undergone significant transformations in recent years, grappling with challenges such as staffing shortages, remote work adaptations, and rising operational costs. Amid these shifts, numerous revenue cycle management (RCM) trends are reshaping how providers approach their revenue operations. In this article, we’ll explore the key RCM trends to watch in 2025 and [...]
Medicare Part D Prescription Coverage in 2025: New Rules, Costs, and Benefits
Medicare Part D plays a crucial role in making prescription medications more affordable for seniors and individuals with disabilities. Many beneficiaries face financial challenges due to rising drug prices. In 2025, new regulations under the Inflation Reduction Act (IRA) will take effect, introducing significant updates to the program. These updates will eliminate the coverage gap, [...]
Healthcare Leaders See AI as the Future of Revenue Cycle Management
FLORIDA, UNITED STATES – The healthcare industry is poised for a major transformation in revenue cycle management (RCM) as artificial intelligence (AI) and strategic outsourcing partnerships gain momentum. A recent study by Everest Group, supported by Omega Healthcare, found that 85% of senior healthcare executives believe AI will significantly enhance RCM performance over the next [...]
Recent studies indicate that prioritizing investments in AI and advanced automation is a key focus for RCM leaders heading into 2025.
A recent Qualtrics market survey conducted by Waystar, a leading healthcare payment software provider, has unveiled the top revenue cycle management (RCM) trends for 2025. The study, which involved 600 healthcare RCM, finance, and technology leaders from provider organizations of various sizes, highlights a strong focus on AI and advanced automation as key priorities for [...]
United States Healthcare Denial Management Market Outlook 2025-2030: Rising Healthcare Denial Rates and AI Innovations Drive U.S. Healthcare Denial Management Market Growth to $8.93 Billion by 2030
The U.S. Healthcare Denial Management Market was valued at USD 5.13 billion in 2024 and is projected to reach USD 8.93 billion by 2030, growing at a CAGR of 9.68%. This growth is primarily driven by adopting new technologies in healthcare denial management and a growing focus on a patient-centric approach. The U.S. healthcare denial [...]
Why Private Equity is Betting Big on Revenue Cycle Management Companies
The healthcare industry is undergoing a seismic shift, driven by regulatory changes, technological advancements, and the growing complexity of financial operations. Amid this transformation, private equity (PE) firms are increasingly turning their attention to revenue cycle management (RCM) companies. These firms, which handle critical financial processes like billing, coding, claims processing, and collections for healthcare [...]
