Latest News & Updates
From regulatory updates to billing trends and reimbursement strategies - an RCM news page that keeps everyone on track.
Optum unveils two new AI tools for digital prior authorization
Optum is launching two AI tools — Digital Auth Complete and InterQual Auth Accelerator — to cut prior authorization delays. Digital Auth Complete integrates into the EHR and automates multiple parts of the process to return responses faster.
UiPath launches agentic AI solutions for healthcare administration
UiPath announced agentic AI solutions for healthcare: medical records summarization, claim denial prevention and resolution, and prior authorization — using agentic automation to accelerate revenue cycle management.
Abridge teams with Availity to scale real-time prior authorization
An integration between Abridge and Availity aims to speed prior authorization from weeks to minutes, shifting the process from post-visit to real time during the patient exam.
Autonomize AI Launches Genie AI Autonomous Agent
Autonomize AI launched Genie AI, a healthcare-native AI agent that lets clinicians, care managers, and operations staff build automated workflows using natural language. The tool targets utilization management, prior authorization, appeals, and care coordination, and is designed to keep generated workflows auditable and governed within existing enterprise systems.
MDaudit Adds Auditor Assist to Its Continuous Risk Monitoring Suite
MDaudit added Auditor Assist, an AI-powered companion that helps human auditors review coding-integrity cases faster while keeping a human in control of the final call. The launch responds to a reported 30% year-over-year rise in payer audit volume, with coding-related denials up as much as 26%.
Black Book Research Recognizes Inovalon for End-to-End Revenue Cycle Platform and Eligibility Intelligence
Inovalon was named a top-rated revenue cycle management vendor by Black Book Research in two categories: full-suite intake-to-final-payment platform breadth, and real-time eligibility and benefits verification. The ranking is based on evaluations from more than 1,300 hospital and health system finance leaders.
CMS CY 2027 Physician Fee Schedule Proposed Rule Includes Interoperability RFI
CMS's CY 2027 Physician Fee Schedule proposed rule includes a Request for Information on duplicate laboratory testing and imaging caused by data siloed within electronic health record systems. Comments on the RFI are due September 14, 2026.
Athenahealth rolls out 80+ AI-native revenue cycle features
Athenahealth built more than 80 AI-native features into athenaOne, targeting high-friction tasks such as insurance verification, coding, prior authorization and denials. AI voice agents place over 23,000 prior authorization calls each month, some completed in under an hour.
States Continue Efforts to Regulate AI in Healthcare: A Review of Legislation Passed in 2026
A 2026 legislative review tracks state laws enacted this year regulating insurers' use of AI in prior authorization and claims decisions. States including Georgia, Maryland, Washington and Utah added disclosure, human-oversight and reporting requirements for AI-assisted adverse determinations.
How AI is transforming revenue cycle management right now
Oliver Wyman's 2026 Healthcare RCM Survey of 200+ decision-makers and 90 end users finds AI adoption moving from pilots to enterprise scale. Ambient documentation, coding automation and electronic prior authorization are the top investment areas cited by respondents.
CMS proposes rule for electronic prior authorization of drugs (CMS-0062-P)
A proposed CMS rule extends electronic prior authorization requirements from non-drug items to drugs, adopts FHIR standards for prior auth transactions and mandates API metrics reporting. Most compliance dates begin October 1, 2027.
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