Revedy Healthcare AI Insights
From Reactive to Proactive: Transforming Denial Management and QA with Intelligent Automation
In any large-scale healthcare RCM operation, two functions consume a disproportionate amount of senior-level resources: Quality Assurance (QA) and Denial Management. Traditionally, these are reactive, manual, and costly processes. A small team of expert coders spends their days spot-checking a fraction of the total work, while another team manually dissects cryptic denial letters to begin…
Beyond Arbitrage: The New Competitive Edge for Healthcare RCM Providers
For over two decades, the healthcare Business Process Outsourcing (BPO) model has been a powerful engine of efficiency, built on a successful foundation of process excellence and labor arbitrage. By leveraging skilled global workforces, RCM providers have delivered immense value to US healthcare systems, helping them manage complex billing cycles and reduce administrative costs. This…
From Intake to Reimbursement: Closing the E M Coding Gap for a Clinical Automation Innovator
Approx. 1,050 words Introduction Your team has already solved one of the most painful parts of outpatient medicine: getting clean, structured data before the visit. Yet there is still a stubborn leak in the value chain. Even when the chart is perfectly pre-populated, physicians often under-document or mis-select Evaluation and Management (E M) codes—leaving revenue…
Cut Denials, Grow Margin: AI Coding Automation for Mid-Sized HIM BPOs
Why This Matters Now A fast-growing Philippine BPO recently crossed the 600-employee mark while broadening from contact center work into full-stack Health Information Management. Expansion is great for topline, yet every additional client magnifies three stubborn problems: Surging claim denials tied to complex CPT changes (think Chronic Care Management or telehealth modifiers). A global shortage…
Solving High-Complexity Surgical Coding for a Physician Enablement Group: A Capital-Efficient AI Pilot
Estimated read time: 7 minutes Introduction Independent physician practices in Southern California are wrestling with shrinking margins, staff shortages, and an increasingly unforgiving payer landscape. Nowhere is the pressure more acute than in high-complexity surgical specialties—think ENT, orthopedics, and neurosurgery—where every missed modifier or overlooked CPT add-on code can translate into thousands of dollars lost…
Closing the Revenue Gap After a County-Wide EHR Migration: How AI-Driven Coding Pilots Deliver Results in 90 Days
Introduction A multi-hospital, county-run health system is in the middle of a massive electronic health record migration while simultaneously staring down a nine-figure deficit. Leadership is being asked to modernize infrastructure, protect patient access, and find millions in new revenue without expanding headcount. Amid these conflicting priorities, one area consistently surfaces as both a pain…
How a Neurodiagnostic Innovator Can Accelerate Adoption and Recurring Revenue with AI-Driven Coding Support
Executive Summary A wave of point-of-care EEG, EMG, and IONM innovations is opening new clinical frontiers, yet reimbursement complexity still slows market penetration and squeezes margins. By embedding AI-powered revenue-cycle automation into your commercial offering, a leading neurodiagnostic device manufacturer can unlock faster sales cycles, stickier service revenue, and the data feedback loop needed to…
Ambulatory Surgery Boom Meets AI RCM Gap: A Playbook for Integrated Health Networks
Executive Summary Northern California’s leading not-for-profit health network is rapidly expanding its ambulatory surgery center footprint while executing a long-term revenue-cycle outsourcing deal. Yet specialty coding blind spots, medical-necessity denials, and payer-response backlogs continue to leak millions in net revenue. This article outlines a capital-efficient, pilot-friendly roadmap to close those gaps with targeted AI—without disrupting…
Automating Complex Home-Health Coding: A Capital-Efficient Path for a Remote Billing Partner
Introduction Margin pressure in revenue-cycle management has never been higher, yet claim volumes keep climbing—especially in home health and hospice. For a lean, fully remote billing partner, the equation is simple but unforgiving: every additional chart requires either more headcount or smarter tools. The good news is that recent advances in applied AI can finally…
AI-Powered Coding Wins for Waiver-Based Telehealth: How Home-Based Care Providers Can Slash Denials and Scale Faster
Introduction Every home-based telehealth visit you deliver is a victory for the member: fewer ambulance rides, better medication adherence, and the dignity of independent living. Yet every visit also creates a paperwork battle. Medicaid waiver billing combines remote patient monitoring, virtual check-ins, behavioral health, and in-home tech support—often in the same day. Each interaction must…