Notes from inside the revenue cycle.
Specific, opinionated writing on billing, clean claims, coding, and what AI actually does in RCM. No fluff.
12 posts
What “autonomous RCM” actually means (and what it doesn’t)
“AI-powered” is doing a lot of work in RCM marketing. Here’s the line between an autonomous agent that completes work and a copilot that just speeds up a person.
How touchless claim submission compresses days in A/R
Most A/R isn’t collected late because of bad follow-up. It’s late because the claim took too long to go out clean. Here’s the front-of-cycle math.
Front-of-cycle vs. back-of-cycle: where automation actually pays
Back-of-cycle automation cleans up messes faster. Front-of-cycle automation stops making them. Here’s why the upstream half pays more — and how to tell the difference.
Why most denials are decided before the visit
Most preventable claim denials do not begin with the payer. They begin with information that could have been verified before the patient was ever seen.
First-pass acceptance: the metric that predicts your cash
First-pass acceptance rate is the front-of-cycle metric that shows where cash is headed before it gets delayed. Here's what it measures, why it matters, and how to move it.
Days in A/R, explained: what actually moves it
Days in A/R is a lagging indicator with an upstream cause. What's healthy, what isn't, and why most of it is decided before submission.
Claim scrubbing: the payer-rule checks that stop rejections
A clean 837 isn't luck. It's the result of payer-rule checks that catch errors before a claim ever leaves the building.
Medicare Part A vs Part B: a clean-submission checklist
Institutional (837I) and professional (837P) Medicare claims follow different rules. Here's a practical clean-submission checklist for Part A and Part B.
ERA/835 posting done right: reconciliation and EOB conversion
Posting isn't data entry. How ERA/835 reconciliation and accurate EOB conversion close your books faster and surface problems sooner.
Connecting RCM to your EHR and PM without a rip-and-replace
You shouldn't have to migrate off your EHR or PM to modernize billing. How integrations, EDI, and FHIR connect RCM to the systems you already run.
Reading about it is one thing. Seeing it run is another.
Watch the five agents take a claim from census to posted payment.