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
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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.
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AWS Connect Health: RCM Salvation or Infrastructure Play?
While the US healthcare system bleeds hundreds of billions annually to administrative waste, tech giants are pitching AI as the ultimate cure. But when evaluating Amazon's new offering, healthcare executives must ask a critical question: AWS Connect Health: Infrastructure Play or RCM Solution? Stripping away the marketing reveals that it is a powerful cloud foundation requiring years of expensive custom development, not a ready-to-use billing platform. Before investing, leaders must decide if they have the engineering budget to build from scratch or if they need an out-of-the-box system that delivers immediate financial ROI.
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Claude for Healthcare Overview | 2026
In January 2026, Anthropic launched Claude for Healthcare at the J.P. Morgan Healthcare Conference - a dedicated toolkit integrating Claude with US medical data infrastructure. This guide covers the full technical architecture, clinical benchmarks, real-world case studies (Banner Health, Novartis, Novo Nordisk), HIPAA compliance details as of April 2026, and a head-to-head comparison with OpenAI's healthcare offerings. Essential reading for anyone planning a healthcare AI implementation.
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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.
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"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.
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"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.
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"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.
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"Net Collection Rate (NCR)" - Term Explanation
Net Collection Rate (NCR) is the percentage of collectible revenue — the maximum allowed under payer contracts — that a provider actually collects. It is the most accurate indicator of billing performance in RCM. Best practice: 95–99%. Anything below 95% means real, recoverable revenue is being left on the table.
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"Charge Capture" - Term Explanation
Charge capture is the process of converting every clinical service documented in the patient record into a billable charge. It is the starting point of the revenue cycle — missed or delayed charges here mean revenue that can never be recovered downstream.
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