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Too often, these stories go untold because the plot details are buried in spreadsheets, lost in static reports, or delivered in formats that fail to connect with leadership’s strategic vision.

For revenue cycle management (RCM), billing compliance, health information management (HIM), and revenue integrity teams responsible for protecting and growing revenues, these untold stories highlight the struggle faced in showcasing their value in a way that drives decisions. The good news is that the battle is not insurmountable; raw data can be converted into compelling, executive-ready narratives that highlight the return on investment (ROI) at every stage of the revenue cycle.

In late 2023, a multi-hospital health system in the Southeast saw a sudden spike in payer requests for documentation. The compliance team had been running routine retrospective audits, but the pace of incoming denials and takebacks began to outstrip their ability to respond. Within six months, the organization reported more than $11 million in at-risk revenue and a doubling of external audit activity.

Despite their best efforts, the system was playing defense.

Few in the healthcare industry question the need to modernize the HIPAA Security Rule, the proposed overhaul of which is expected to be finalized in 2026. But even if the final rule is modified to scale back requirements or lengthen timeframes, compliance will be a heavy lift for many physician practices, hospitals, and health systems.

That reality, coupled with the common-sense need for robust security around protected health information (PHI) and other patient data, makes procrastination a compliance strategy that is doomed to fail.

Healthcare revenue cycle management (RCM) is at a breaking point. Escalating claim denials, shrinking reimbursements, and persistent staffing shortages are forcing finance leaders to rethink traditional approaches. With 84% of health system executives identifying denials as a top threat to financial margins, the pressure to optimize RCM processes has never been greater.

While robotic process automation (RPA) bots have streamlined repetitive tasks, their rigid, rule-based nature struggles with the dynamic complexities of modern RCM.

Merger and acquisition (M&A) activity continues at a rapid pace, posing a risk to data integrity. As impacted hospitals and health systems seek to consolidate their operations and technologies, duplicate and crossover records surge.  While these errors present immediate challenges, the longer-term concern lies in maintaining the accuracy and integrity of patient data across newly merged systems.

We sat down with Harris Data Integrity Solutions’ executive vice president, Rachel Podczervinski, MS, RHIA, and director of industry relations, Julie A. Pursley, MSHI, RHIA, CHDA, FAHIMA, for an in-depth exploration of the obstacles confronting those tasked with maintaining the accuracy of patient data in a rapidly consolidating healthcare environment.

Advances in artificial intelligence (AI) and automation have given rise to the next-generation digital workforce in healthcare revenue cycle management (RCM): Agentic AI.

The value of agentic AI, and other forms of digital agents, is not only their ability to accelerate task completion with greater accuracy but also to accomplish judgment and logic-driven tasks usually reserved for humans. Claim follow-ups, denial prevention, eligibility verification, data and payment reconciliation, and patient financial engagement are all high-complexity tasks requiring nuanced human judgment that are ideal for agentic AI. Digital agents also help ease the burden on RCM teams, which are already stretched thinly due to chronic workforce shortages.

The AI Journal»

Wellesley, MA  – October 21, 2025 – MDaudit, an award-winning cloud-based continuous risk monitoring platform for RCM that enables the nation’s premier healthcare organizations to minimize billing risks and maximize revenues, joins the American Health Information Management Association^® (AHIMA) in a dynamic film series that shines a light on the vital work of health information (HI) professionals at the intersection of care, technology, and policy. Health Information: Making Every Patient’s Story Matter showcases how HI professionals safeguard sensitive data, improve patient outcomes, and shape smarter and more connected healthcare systems through a series of short films, expert interviews, and real-world case studies.

More than 70% of IT leaders say regulatory compliance is a top concern while deploying generative AI — and the spate of AI regulations have only just begun.

WASHINGTON, D.C. – September 30, 2025 – AGS Health, a leading provider of tech-enabled revenue cycle management (RCM) solutions and a strategic growth partner to healthcare providers across the U.S., has been named a recipient of the UiPath AI25 Award for its pioneering use of agentic AI automation to assist healthcare providers in managing the rising rate of costly healthcare claim denials.

In recognition of 2025 World Patient Safety Day today (Sept. 17), the theme of which is “safe care for every newborn and every child” in recognition of the vulnerability of this age group to risks and harm caused by unsafe care, the EHR Association’s Patient Safety Workgroup shares the following statements:

At the 61st annual European Association for the Study of Diabetes Conference (EASD) this week in Vienna, Austria, glucose monitoring company Dexcom introduced its new offering, the Dexcom Smart Basal, an integrated titration module aimed at making basal insulin initiation and management easier for users.

According to Johns Hopkins, basal insulins are intermediate and long-acting insulins that are prescribed for patients with type 1, type 2 or gestational diabetes.

In a letter to the Centers for Medicare and Medicaid Services, the HIMSS Electronic Health Record Association said a proposed reporting timeline in the 2026 Outpatient Prospective Payment System/Ambulatory Surgical Center Proposed Rule is too aggressive.

Health IT vendors and hospitals need more time to develop and implement the necessary software and staff training, said EHRA leaders.

Healthcare IT News»

Efficient revenue cycle management (RCM) is a persistent challenge for healthcare organizations. It encompasses patient registration, coding, billing, claims submission, and collections. These processes are complex, labor-intensive, and prone to error. In fact, administrative costs account for over 40% of U.S. hospital expenses, amounting to roughly US$ 160 billion each year on RCM activities. Amid this scale of spending, even a few percentage points of errors or denials translate to billions of dollars in lost revenue.

For example, recent government figures show that Medicare Fee-for-Service had an estimated 7.66% improper payment rate in FY2024, reflecting widespread billing and coding errors. Moreover, CMS notes that the ‘vast majority’ of these improper payments occur because claims lack sufficient documentation. This finding suggests that many payment errors are avoidable with better data capture and review.

ARLINGTON, Va. – Sept. 11, 2025 – FriskaAi, an innovative healthcare platform that leverages advanced AI and mobile technology to help individuals manage their health in collaboration with their physicians, today announced three key appointments to its leadership team: Doug Stewart as vice president of Practice Success; Fjorino Musaku, M.Ed., CDCES, as a health and wellness coach; and Kristin Gahwiler as senior fitness consultant.

There’s a quiet truth running beneath the flood of headlines about ransomware in healthcare: the breach isn’t always the worst part.

I’ve worked with healthcare and dental practices for more than two decades, from busy urban outpatient clinics to multi-site dental groups in rural towns. The story that rarely makes the news is what happens after a cyberattack: the calls from providers whose practices have come to a complete standstill, staff resorting to manually pulling paper charts, and owners left to calculate whether they’ll be able to reopen. I’ve heard the fear and anxiety in the wake of a cybersecurity incident, being told on more than one occasion, “I wasn’t scared when it happened. I was scared when I realized how long we’d ignored it.”

Health IT Answers»