Arintra’s $25M Raise Signals a Denial-Prevention Shift
Arintra’s $25M Series B points to AI-driven coding accuracy, not just claims-processing speed, as the real lever against payer denials this year.
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Prior Auth Automation Raises the Bar on Coding Accuracy
R1’s Humata Health deal shows prior-auth automation is tightening the link between coding accuracy and claims approval — and raising the cost of coding errors.
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ModMed’s Agentic RCM Launch Signals Where AI Coding Is Headed
ModMed’s agentic RCM platform folds coding guidance into denial prevention and appeals — a sign that coding accuracy and revenue recovery are converging.
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CMS RAPID Coverage Pathway: The Medical Coding Gap
CMS’s RAPID pathway can post a Medicare coverage decision the same day a device wins FDA authorization — but HCPCS codes and payment rules still take months to catch up.
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CMS’s CY2027 Rule Moves 638 Procedures to Outpatient Coding
CMS’s CY2027 proposed rule would shift hundreds of procedures out of inpatient-only status, creating a major coding and revenue-cycle readiness challenge for hospitals and ASCs.
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Modifier 25 and CMS’s 2027 Same-Day E/M Payment Cut
CMS’s CY2027 proposed rule would pay same-day E/M visits billed with modifier 25 at just 50%. Here’s what the change means for coders and denial teams now.
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How Agentic AI Closes the Hospital Underpayment Gap in RCM
Underpayments silently cost hospitals 2-5% of net revenue every year. Agentic AI is now closing that gap by modeling every payer contract automatically.
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Experity Acquires Exdion to Automate Urgent Care Coding
Experity acquired Exdion Healthcare on July 1, 2026, uniting the #1 urgent care EHR with AI-powered coding automation that delivers 86% fewer denials for 6,700+ clinics.
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Elevance’s $342M MA Repayment: What HCC Coders Must Know
CMS forced Elevance Health to repay $342M in Medicare Advantage overpayments. Here’s what this landmark enforcement action means for HCC coders.
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Maia AutoCoder: AI Targets Orthopedic Coding Revenue Gap
Maia just closed a $1.2M seed round for AutoCoder, an AI platform built exclusively for orthopedic CPT coding — because generic tools miss too much revenue.
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