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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AI Denial Prevention: How FinThrive Is Shifting RCM Strategy
FinThrive’s Denials Prevention Manager — showcased at HFMA 2026 — signals a major shift from chasing appeals to stopping denials before they start.
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How Agentic AI Writes Denial Appeal Letters That Win
AI-powered agents draft denial appeal letters that cite clinical evidence and map to payer policy — winning more reversals faster.
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