John Kuhn

Next year, Epic will expand its AI capabilities, specifically by enhancing the process for appealing denied insurance claims. Speaking at last month’s HLTH USA conference, Epic executive Mike Pontillo said the EHR giant is looking at various areas to expand. “It’s about trying to figure out what are the use cases that'll free people up to practice at the highest level either for their license or their role,” he said. Our expert consultants help healthcare organizations get the most benefit out of their Epic investments. Find out more in the comments below. Read about Epic’s plans: https://lnkd.in/gwgkthr6 I #Epic #EHR #HealthTech #HealthcareInnovation #Interoperability #HealthData Modern Healthcare

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What's your winning strategy for healthcare's claims game? Kathleen Quill Noyes, MHA, CPC, CRCR shares her cautious optimism in exploring #AI for healthcare #revenuecycle. "Everyone's really focused on how quickly they can absorb AI and how quickly they can apply it to their revenue cycle and their processes––and that's exciting. But don't wait until the perfect moment or until that next big thing (to get started)," she says. Watch the video interview: https://lnkd.in/g6pFF3Wd #revenuecyclemanagement #healthcare

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In a recent article on Digital Health Insights, author Jennifer Bresnick discusses how CMS is lighting a fire under payers to compete on value with 1upHealth's CSO Donald Rucker. Topics include the power of modern data standards (i.e., FHIR) and CMS-mandated APIs to provide transparency around outcomes and cost (i.e., value). 🔥 Don says in part, “FHIR creates the ability to bring financial and clinical data together in a meaningful way so that we can finally draw back the veil on why we spend the most but have some of the worst outcomes in the world. We can begin to codify and compute our definitions of value – and start to compete on that value. You can choose to be threatened by that, or you can choose to make it work for you. The organizations that are going to survive are the ones that pick the latter.” 📰 Read the full article to learn more.  https://lnkd.in/eaYdEqBr #fhir #cmsapis #value

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📊 Claims data is not enough. Are we missing the full picture when it comes to patient care? In our latest feature, our CEO Jeff Wandzura, RPh, dives into a critical issue: the limitations of relying on payment/claims data to measure real-world medication use. As more specialty medications shift from clinics to homes, it’s clear that traditional data streams aren’t keeping up with the evolving landscape of patient care. Jeff shares insights on: 1. Why relying solely on claims data leaves dangerous gaps in understanding patient adherence. 2. The impact of missing visibility into patients' home-based medication journeys. 3. How closing this data gap can improve patient outcomes, especially for complex therapies. 📈 By shifting from retrospective to proactive care, we can help patients get more from their medications while driving smarter interventions. 🔗 Read the full piece here: https://lnkd.in/gEbMxxKp What are the biggest challenges you're seeing in patient support programs today? Comment below and let’s explore what we are seeing. #HealthcareInnovation #PatientCare #PharmaTech #SpecialtyPharmacy #MedicationManagement #RealWorldEvidence #HealthData #PatientSupport #HomeHealthcare #PatientJourney #MedicalTechnology #DigitalHealth #PharmaInsights #ChronicCare

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🚀 Willow (YC S24) launched! AI-Powered Revenue Cycle Management for Long-Term Care "Maximize Your Medicare and Medicaid Reimbursement with AI" 🌐 www.seewillow.com 💡 A team of Stanford and Yale students and researchers are helping skilled nursing facilities maximize Medicare reimbursements and reduce administrative burden with AI. Check them out and contact the founders via email for more! 🎯 Willow currently focuses on one of the most tedious and high-impact areas for maximizing reimbursement in the revenue cycle: post-acute coding. 📈 Starting with the intake and coding process for skilled nursing facilities, Willow maximizes reimbursement by converting complex clinical paperwork into accurate diagnoses and ICD codes. 🤖 It's AI automates the translation of complex clinical documentation into accurate diagnoses and billing codes. This reduces errors and ensures facilities capture all eligible reimbursements. 🔄 They’re expanding this technology to cover and increase accuracy for the entire billing process. 🤝 Willow is looking to connect with professionals in skilled nursing facilities who could benefit from their product ‍ 📧 If you know any leadership at facilities, such as administrators and directors, corporate leadership, certified professional coders, or certified professional billers, please connect them with the founders! Congrats Allan G., Ian Ye, Steven Zhou & Lawrence Liu!! ‍ https://fondo.info/4gHC9AU

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The healthcare industry is taking steps toward what Gartner calls an ecosystem approach to customer engagement. 🌐 Blue Shield of California's 𝗠𝗲𝗺𝗯𝗲𝗿 𝗛𝗲𝗮𝗹𝘁𝗵 𝗥𝗲𝗰𝗼𝗿𝗱 𝗽𝗹𝗮𝘁𝗳𝗼𝗿𝗺 will consolidate health data from both claims and providers into a single location. This comprehensive view will be available online and through the Blue Shield app, providing members with a holistic view of their health. 𝘠𝘰𝘶 𝘤𝘢𝘯 𝘴𝘦𝘦 𝘴𝘰𝘳𝘵 𝘰𝘧 𝘢 𝘣𝘪𝘨 𝘱𝘪𝘤𝘵𝘶𝘳𝘦 𝘰𝘧 𝘺𝘰𝘶𝘳 𝘩𝘦𝘢𝘭𝘵𝘩, 𝘢𝘯𝘥 𝘺𝘰𝘶 𝘤𝘢𝘯 𝘮𝘢𝘬𝘦 𝘦𝘮𝘱𝘰𝘸𝘦𝘳𝘦𝘥 𝘥𝘦𝘤𝘪𝘴𝘪𝘰𝘯𝘴 𝘢𝘳𝘰𝘶𝘯𝘥 𝘺𝘰𝘶𝘳 𝘩𝘦𝘢𝘭𝘵𝘩, 𝘯𝘰𝘵 𝘫𝘶𝘴𝘵 𝘺𝘰𝘶𝘳 𝘩𝘦𝘢𝘭𝘵𝘩, 𝘣𝘶𝘵 𝘢𝘭𝘴𝘰 𝘵𝘩𝘦 𝘩𝘦𝘢𝘭𝘵𝘩 𝘰𝘧 𝘺𝘰𝘶𝘳 𝘥𝘦𝘱𝘦𝘯𝘥𝘦𝘯𝘵𝘴. - Jigar Shah, Chief Marketing Officer for Blue Shield of California Simplifying the patient journey starts with giving patients access to their data, all of it, and helping them get the most value out of that data by providing the tools and guidance they need based on where they are in their care journey. #healthrecords #memberengagement #patientexperience #healthIT

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📢 Update for Health Tech Innovators! 📢 The FTC has finalized changes to the Health Breach Notification Rule (HBNR), now including health apps and technologies not subject to HIPAA. In our latest article, "FTC's Expanded Health Breach Notification Rule: What Health App Developers Need to Know," we break down: 👉 The expanded interpretation of the HBNR 👉 Applicability to non-HIPAA-covered entities 👉 Key changes in the 2024 Final Rule Understand how these changes impact your health tech solutions today 👉 https://lnkd.in/eKV6qe7m #HealthTech #FTC #HBNR #DigitalHealth #DataPrivacy #DigitalHealth

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Thought provoking conversation between our CEO, Mike Desjadon and CNBC's Tyler Mathisen on The Exchange yesterday discussing the role of #AI in driving #transparency and #predictability into #healthpayment. With the technological horsepower of #AI applied to #healthpayment, its now possible to know in advance what benefits are in a plan, what these plans cover and what needs to be done to make sure payments are adjudicated correctly (the first time), and people get the care they need without the anxiety of what what might wind up in their mailbox 30 days later. This is better for everyone, provider, payer and patient alike. We're here for that future. "Payers and providers can partner together on transparency using these technologies" - Mike Desjadon https://lnkd.in/gNinRjXK

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The future of healthcare is built on strategic partnerships that combine expertise and technology. Our Strategic Partnerships enable companies to leverage: ➤ Single API connection that provides a seamless all-payer claims management workflow ➤ Real-time access to the industry's largest primary source, longitudinally linkable dataset ➤ Full visibility into Medicare claims, remits status, and eligibility, helping customers overcome Medicare's DDE complexity (Inovalon is the largest and longest-standing Network Service Vendor) ➤ Suite of cloud-based APIs with pre-written requests and export code in multiple languages When companies partner with Inovalon, they gain access to a trusted ally in transforming healthcare with data and innovation. Learn more about our Strategic Partnerships: https://ow.ly/ttZy50Ua5Uh #StrategicPartnerships

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We are proud to be featured in Modern Healthcare's article on how AI is transforming the #priorauthorization process for both providers and insurers. As Jeremy Friese, MD our CEO, explained: "There's a lot of opacity in the problem, and so what we try to do is highlight what the medical necessity rules are, and then help providers submit higher-quality prior authorizations to achieve higher success rates for approval." By working together, we can reduce administrative burdens, enhance transparency, and ultimately improve patient outcomes. This is innovation driving meaningful change – and we're just getting started. Read the full article here: https://bit.ly/priorauthai

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Are you facing mounting administrative burdens or grappling with data fragmentation and interoperability issues? These are some of the top challenges health plans encounter today. At the upcoming New York Health Plan Association conference, April Gill will be diving into Practical AI Solutions that Impact Health Plan Efficiency, offering insights on how #SDS and AI can help. If you’re ready for fresh ideas that can reshape how you operate, schedule a meeting now! https://hubs.li/Q02YnFLb0 #NYHPA2024 #HealthcareAutomation #HealthPlans #HealthcareEfficiency

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The partnership between @Salesforce and Shield of California shows how #AI is transforming prior authorization. By identifying cases that meet approval criteria, AI can reduce the administrative burden on clinicians, speed up decisions, and free up time for more complex cases. This kind of data-driven efficiency has the potential to turn weeks-long delays into same-day approvals, easing one of healthcare's most burdensome processes. https://yhoo.it/4fVrIIO #healthcarefinance #healthtech

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👀 ICYMI: Last week Modern Healthcare dove into the growing use of AI at health systems to help limit and challenge the dramatic rise in insurance denials. 🗣️ Nate Wilson, Regard's cofounder and President, spoke with Lauren Berryman and highlighted Regard's impact:  1️⃣ Reduces the burden on doctors 2️⃣ Protects health system revenue and prevents denials 3️⃣ Most importantly, improves patient care Read the full article here: https://lnkd.in/eyUBmiaX #aihealthcare #healthcare #digitalhealth

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Thanks to Meditech Today for sharing Saul Marquez's contributed article on strategies to market more effectively to payers and providers. In a noisy market, only the best at getting their message to their target audience will effectively help #transform #healthcare. Payers and providers are busy with operations and patient care, and if we're intentional with our marketing and outreach strategy, they will hear our message. If we're not, they won't. Check out the tips and tricks below - they are very digestible and actionable. https://lnkd.in/eENbQ4WU

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New blog post by David Hewitt, "Top 6 Reasons Hospitals Must Focus On Uncovering The Dark Data In The Cost Cycle." Boost financial performance, decision-making, and patient outcomes by prioritizing dark data in 2024. #spendmend #healthcareData #darkdata #hospitals

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🚨 𝗘𝘅𝗰𝗶𝘁𝗶𝗻𝗴 𝗧𝗿𝗲𝗻𝗱𝘀 𝘁𝗼 𝗪𝗮𝘁𝗰𝗵 𝗮𝘁 𝗛𝗟𝗧𝗛 𝟮𝟬𝟮𝟰 🚨 As HLTH 2024 unfolds this week, industry leaders are excited to discuss key trends and innovations reshaping healthcare.  🔹 𝗔𝘃𝗶 𝗠𝘂𝗸𝗵𝗲𝗿𝗷𝗲𝗲 (𝗩𝗲𝗿𝗮𝘁𝗼) emphasizes the critical role of trusted data when it comes to AI. With AI-powered tools like NLP, ML, and Gen AI, Avi predicts transformative improvements in ROI and care delivery. 🔹 𝗥𝗮𝗷𝗲𝗲𝘃 𝗥𝗼𝗻𝗮𝗻𝗸𝗶 (𝗟𝘆𝗿𝗶𝗰) talks about focusing on creating ethical, cross-disciplinary ecosystems where responsible AI becomes a core part of operations. 🔹 𝗖𝗼𝗹𝗶𝗻 𝗕𝗮𝗻𝗮𝘀, 𝗠𝗗 (𝗗𝗿𝗙𝗶𝗿𝘀𝘁) sees a shift towards hybrid EHR solutions, emphasizing agility and specialized partnerships over traditional monolithic systems. Check out these predictions and more. https://lnkd.in/e2vkB3sY What trends are you most excited to see at HLTH? Verato team members David Beck and Joshua Firstenberg will be onsite to discuss. #HLTH2024 #HealthcareIT #AI #EHR #PatientCare

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FHIR® APIs are required to meet the new CMS-0057-F mandate for data exchange and prior authorization. But they can be used for so much more and to maximize that potential, you need a partner who is an expert. In the 2024 Gartner® Hype Cycle™ for U.S. Healthcare Payers, FHIR APIs are noted for their business impacts by “establishing standards-based information usage that improves collaboration and workflow integration,” and “decreasing time to value for data-sharing initiatives.” Smile Digital Health, named a Sample Vendor in the report for FHIR® APIs, is here to help. Learn about how Smile’s CMS Suite and FHIR APIs keep you compliant while also supporting your data modernization efforts: https://lnkd.in/gtWZG7zB Access your complimentary copy of the Gartner® report here: https://lnkd.in/ghDGvjUA #Gartner #FHIR #CMS0057F

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