Everything you wish someone told you about automating RCM
From failed bots to million-dollar recoveries – stories, frameworks, and lessons from the field.
Featured insights
.png)
The State of Claim Denials in U.S. Healthcare
Denials didn't get better in 2025. They got worse – and the data shows exactly where, why, and by how much. Every RCM leader has a gut sense that denials are climbing. What's harder to find is a single place that pulls together what the national numbers actually say: how much revenue is on the line, which denial types are driving the increase, what prior authorization is doing to physicians and patients, and how much of this is actually fixable with the automation and AI tools available today.This report pulls from the primary sources that matter – Kodiak Solutions' benchmarking data, the American Hospital Association, CMS's own prior authorization disclosures, the AMA's physician survey, and the CAQH Index – to build that single reference point.
.png)
.png)
The State of Claim Denials in U.S. Healthcare
Denials didn't get better in 2025. They got worse – and the data shows exactly where, why, and by how much. Every RCM leader has a gut sense that denials are climbing. What's harder to find is a single place that pulls together what the national numbers actually say: how much revenue is on the line, which denial types are driving the increase, what prior authorization is doing to physicians and patients, and how much of this is actually fixable with the automation and AI tools available today.This report pulls from the primary sources that matter – Kodiak Solutions' benchmarking data, the American Hospital Association, CMS's own prior authorization disclosures, the AMA's physician survey, and the CAQH Index – to build that single reference point.
.png)
.png)
XiFin - 101 Guide
When a private equity firm holds a healthcare technology company for twelve years–nearly double the industry standard–it tells a story. Whether that narrative speaks to product maturity or exit market challenges remains an open question, and one that diagnostic billing leaders should answer before signing multi-year contracts with XiFin. This article is exactly about this.
.png)
"Digital Patient Engagement" - Term Explanation
Digital patient engagement refers to the front-end digital tools — portals, mobile apps, online scheduling, and digital billing — that connect patients to their care and financial responsibilities before and after the visit. It directly affects patient payment rates, which have become one of the hardest collection challenges in RCM.
.png)
"Health Insurance Portability and Accountability Act (HIPAA)" - Term Explanation
HIPAA is the federal law governing privacy, security, and electronic transmission of protected health information in the U.S. For RCM teams, it is a non-negotiable operational framework — every step of the billing cycle handles PHI and must comply. Violations carry penalties up to $1.9M per category annually, plus mandatory breach notifications.
.png)
.png)
"Protected Health Information (PHI)" - Term Explanation
PHI is any individually identifiable health information — clinical, demographic, or financial — linked to a patient's health condition or care. Under HIPAA, every RCM workflow that touches patient data is a PHI handling activity requiring specific security, access, and transmission controls. PHI breaches carry civil penalties up to $1.9M annually plus mandatory patient notifications.