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 [...]
U.S. Healthcare Denial Management Market to Reach $8.93B by 2030, Driven by Rising Denials & AI Innovations
Market Overview 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 driven by the increasing adoption of advanced technologies in denial management and a shift toward a more patient-focused approach. The [...]
Healthcare RCM Software Market to Surge by $54.95 Billion (2025-2029), Fueled by AI and Revenue Optimization
The healthcare revenue cycle management (RCM) software market is set for rapid growth, projected to expand by $54.95 billion between 2025 and 2029. As the demand for minimizing revenue leakage increases, opportunities within the sector continue to emerge. However, interoperability challenges remain a key obstacle to seamless adoption and growth. Drivers & Challenges in the [...]
RCM Solutions Are Growing, What It Means for Rev Cycle Leaders
The revenue cycle management (RCM) market is experiencing significant growth, with projections estimating its value to reach between $343 billion and nearly $900 billion globally within the next decade, according to reports from Straits Research and Coherent Market Insights. The outsourcing segment alone, currently valued at $90 billion, is expected to grow to $170 billion [...]
