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Prior authorization has long been a burden for organizations, creating delays, denials, and inefficiencies across the revenue cycle. CMS-0057-F aims to modernize those processes by introducing: FHIR-based APIs Faster decision timelines Greater transparency But as payers implement these requirements, what steps do organizations need to take now to move toward automated workflows and away from […]The post CMS-0057-F: Take these 4 steps for interoperable prior authorization appeared first on Waystar.
Rural hospitals and providers play an essential role in keeping care close to home for the communities they serve. As healthcare organizations navigate increasing financial pressure due to fluctuations in Medicaid and ACA coverage as well as regulatory changes, many are exploring practical ways to strengthen financial performance, reduce administrative burden, and build a more […]The post Funding for rural healthcare: How to use RHTP funds to strengthen financial stability appeared first on Waystar.
AI in healthcare is entering a new phase: action. What started as early pilots and isolated use cases is now embedded in revenue cycle workflows: guiding decisions, automating tasks, and improving outcomes. At HIMSS 2026, Waystar hosted an executive Q+A on scaling generative and agentic AI. The discussion revealed a clear shift: AI is no longer […]The post 4 ways agentic AI in healthcare is reshaping the revenue cycle appeared first on Waystar.
Note: this post was originally published in March 2020 and was updated July 2026. Prior authorization is used as a tool to ensure high quality of care while controlling healthcare spending. However, the process itself is extremely labor-intensive and has become a significant source of administrative burden for providers and health plans alike, with 40% […]The post Prior authorization: 3 processes you need to automate appeared first on Waystar.
Healthcare organizations are managing increasingly complex workflows across clinical, financial, and payer-driven processes that don’t always work seamlessly together. These areas include patient payments, utilization management review, and patient billing — where RCM innovations like agentic AI and advanced automation can quickly improve efficiency and outcomes. However, identifying the right solutions and successfully integrating them can still be difficult. Through the Waystar […]The post 4 ways early adopters are driving RCM innovation appeared first on Waystar.
Healthcare revenue cycle leaders are navigating a difficult balancing act: improving financial performance while reducing administrative burden, managing cost, and adapting to rapid technology change. AI and advanced automation create new opportunities to streamline workflows and improve outcomes, but successful strategy requires more than adopting the latest tool. Leaders need solutions that fit their operations, […]The post 5 priorities shaping healthcare revenue cycle strategy appeared first on Waystar.
The healthcare revenue cycle is entering a new era — one powered by AI intelligence, advanced automation, and connected workflows that continuously adapt. From rising administrative burden to payer complexity and silent denials to growing patient financial responsibility, providers are facing mounting pressure across the revenue cycle. During the Spring 2026 Waystar Innovation Showcase, Waystar leaders highlighted the latest AI-powered innovations in healthcare payments. The exclusive […]The post 4 AI innovations accelerating the autonomous healthcare revenue cycle appeared first on Waystar.
Each year, Medicare reimbursement feels less predictable. In 2026, revenue cycle leaders face a convergence of forces: policy shifts, recalibrated payment formulas, tight telemedicine rules, and payer behaviors that quietly erode margins. Medicare remains the bellwether — and when federal policy changes, commercial payers tend to follow. Here are 4 key changes to Medicare reimbursement in 2026 that leaders need to understand now.   MEDICARE REIMBURSEMENT IN 2026: TREND […]The post Medicare reimbursement in 2026: What’s changed + ways to be proactive appeared first on Waystar.
Recoupments — also known as takebacks or chargebacks — cost healthcare providers more than $1.6 billion every month. Yet despite the staggering financial impact, recoupments in healthcare remain a largely misunderstood, under-discussed, and poorly addressed challenge in the healthcare revenue cycle. Recently, healthcare leaders from SCA Health and Cleveland Clinic discussed the pain points of recoupments at Waystar True North™ during a panel discussion. In […]The post The hidden cost of recoupments in healthcare – Q+A with Cleveland Clinic + SCA Health appeared first on Waystar.
AI is one of the most talked-about topics in healthcare payments. But for leaders, one big question remains: How can my team leverage AI in healthcare revenue cycle management (RCM) today to reduce denials, streamline workflows, and deliver ROI? In a recent panel discussion featuring leaders from Waystar and Google Cloud, experts explored what’s delivering ROI now, what to expect next, and why now is the moment to act. […]The post Waystar + Google Cloud: How is AI transforming healthcare revenue cycle management? appeared first on Waystar.
