Author: The PMB Pulse

Technology in the Hands of Seniors

Technology in the Hands of Seniors mlove Thu, 10/30/2025 – 08:48 It started with a high school typing course. Wanda Woods enrolled because her father advised that typing proficiency would lead to jobs. Sure enough, the federal Environmental Protection Agency hired her as an after-school worker while she was still a junior. Her supervisor “sat […]

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Medicare Improperly Paid DMEPOS Suppliers $22.7M

Medicare Improperly Paid DMEPOS Suppliers $22.7M mherndon Tue, 10/28/2025 – 14:17 WASHINGTON—A recent report shows Medicare has continued to improperly pay millions for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) provided to enrollees during inpatient stays despite a major audit in 2018 and subsequent fix in 2020. A Look at the Numbers An audit […]

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AI technology in healthcare: How it’s transforming the industry

Key takeaways: Artificial intelligence (AI) is changing how healthcare organizations operate, but while most providers believe in its potential, adoption is uneven. As payers use AI to control costs, providers must apply the same technology to address rising claim denials and data quality challenges. Experian Health’s AI Advantage and Patient Access Curator help providers prevent […]

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Case Study: How Patient Estimates helped UTMC comply with Price Transparency Rules

In this article… Challenge: Meeting new price transparency regulations Solution: Updating your price transparency strategy Outcome: Improved compliance & clear price estimates “Experian Health helped us meet the compliance of the Price Transparency Rule. Without it, we would have been subject to large fines.” — Marianna Ross, Manager of Customer Services and Financial Counseling at […]

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AAAA (the four A)

By JACOB REIDER I haven’t blogged this yet, which kinda surprises me, since I find myself describing it often.  Let’s start with an overview. We can look at health information through the lens of a lifecycle.  The promise of Health Information Technology has been to help us – ideally to achieve optimal health in the people […]

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Reimagining patient access: AI at the epicenter of coordinated benefits management

Healthcare claims denials are on the rise, despite more than a decade of industry-wide technological advances aimed at improving claims management processes. However, in recent years, the introduction of artificial intelligence (AI) into the healthcare ecosystem has begun transforming how healthcare organizations manage patient access — and the entire revenue cycle. The State of Claims: […]

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Healthcare claim denial statistics: State of Claims Report 2025

Key takeaways: As claims denial rates continue to climb, pressure is mounting on healthcare organizations to find new ways to reduce denials. Leveraging artificial intelligence (AI) and automation-based tools, like Experian Health’s AI Advantage and Patient Access Curator solutions, is proven to lower denial rates. More than half of survey respondents say they’d replace existing […]

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Case study: How USA Health cut manual work by 50% with automated authorizations

“We knew we needed to transform our authorization workflow processes. We were experiencing a high rate of denials due to a lack of authorizations.” – Amy Grissett, Senior Director of Ambulatory Revenue Cycle at USA Health Challenge: Manual processes that couldn’t keep up Serving more than 250,000 patients each year across hospitals, specialty centers and […]

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How propensity-to-pay ​​models help healthcare providers improve collections

Key takeaways: Healthcare organizations are facing growing levels of bad debt and a sharp decline in collections. Propensity-to-pay models that utilize machine learning and robust data offer insight into a patient’s likelihood to pay and allow staff to focus their collections efforts where they matter most. In 2024, Experian Health clients that implemented Collections Optimization […]

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Q&A: How AI innovation is transforming healthcare revenue cycle management

Healthcare organizations are facing a perfect storm: rising claim denials, evolving payer rules, and patients expecting providers to reduce error rates that impact patient billing accuracy. Artificial intelligence (AI) has raised the stakes, causing revenue cycle leaders to feel the pressure to modernize quickly. According to Experian Health’s State of Claims 2025 survey, 73% of […]

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