Tech Mahindra and Abacus Insights partner for healthcare data compliance

Nearly 83% of prescription transactions, 71% of total healthcare spend, and 93% of Medicare costs depend on secure, seamless data exchange. CMS-0057-F mandates APIs and data-sharing by January 2027, affecting thousands of payers and streamlining prior authorization timelines by up to 50%, ultimately reducing patient wait times, administrative burden, and costs.. Tech Mahindra and Abacus Insights strategic partnership is to revolutionize healthcare data interoperability and simplify compliance for U.S. payers to deliver FHIR-based, audit-ready data exchange across multiple states, enhancing accessibility for 30+ million members… Ravinder Singh Mahesh Rajamani Pandiaraj Porselvan Ali Syed Dinesh Kumar, CPHIMS, PGP-AIFL, PMP Chandramouliswaran Janaardhanan Pradeep Ranjan Devender Gupta LakshmiNarayanan Srinivasan Shashank Chunchula Girish Ramiah

The One Big Beautiful Bill Act (OBBBA) is more than just new legislation, it’s a wake-up call for healthcare payers. As part of the latest federal budget reform, OBBBA introduces sweeping changes that will reshape eligibility, enrollment, and member experience across the industry. In our latest blog, Ramaswamy Rajagopal and Heather Hodges break down the key provisions of the bill and share 5 strategic priorities to help payers shift from reactive compliance to proactive resilience. From enhancing member satisfaction to investing in scalable, tech-driven platforms—including emerging capabilities in generative and agentic AI—these strategies are designed to help organizations weather disruption and thrive in a rapidly evolving landscape. Read the full blog: https://cgnz.at/6048sPAiQ #HealthcarePayers #OBBBA #HealthPolicy #DigitalTransformation Cognizant

Is your practice leaving money on the table? New data from 2025 shows a startling trend: **41% of healthcare providers now face claim denial rates of 10% or higher.** This isn't just a billing headache; it's a significant drain on your revenue cycle. The top culprits for denials remain consistent: missing data (50%), authorization issues (35%), and inaccurate patient registration (32%). With 68% of providers finding it harder to submit "clean" claims than a year ago, it's clear that traditional methods are no longer enough. Staffing shortages (affecting 43% of providers) further compound the problem, leading to a cycle of errors and rework. So, what's the solution? While 67% of healthcare leaders believe AI can solve these challenges, only 14% have adopted it. Yet, of those who have, a massive 69% report a reduction in denials and an increase in successful resubmissions. At Florida Health Partners, we specialize in breaking this cycle. We leverage technology and expertise to streamline your revenue cycle, reduce denials, and ensure you get paid for the care you provide. **How is your practice navigating the increasing complexity of claim submissions?** Share your thoughts below! #HealthcareAdministration #RevenueCycleManagement #MedicalBilling #HealthcareFinance #FloridaHealth

𝗗𝗲𝗻𝗶𝗮𝗹𝘀 𝗱𝗼𝗻’𝘁 𝗷𝘂𝘀𝘁 𝗶𝗺𝗽𝗮𝗰𝘁 𝗳𝗶𝗻𝗮𝗻𝗰𝗲𝘀—𝘁𝗵𝗲𝘆 𝗵𝗶𝗻𝗱𝗲𝗿 𝗽𝗮𝘁𝗶𝗲𝗻𝘁 𝗰𝗮𝗿𝗲. 𝗪𝗵𝗮𝘁 𝗶𝗳 𝗔𝗜 𝗰𝗼𝘂𝗹𝗱 𝘁𝘂𝗿𝗻 𝘁𝗵𝗶𝘀 𝗮𝗿𝗼𝘂𝗻𝗱? In healthcare, claim denials remain one of the toughest challenges. Lengthy manual reviews, complex payer rules, and constant rework not only strain resources but also affect cash flow and care delivery. With 𝗛𝗲𝗮𝗹𝘁𝗵𝗙𝗔𝗫™ 𝗗𝗲𝗻𝗶𝗮𝗹 𝗠𝗮𝗻𝗮𝗴𝗲𝗺𝗲𝗻𝘁, healthcare providers can now: ✔ Detect high-risk claims before submission ✔ Streamline appeals with AI-generated documentation ✔ Monitor payer policies in real time ✔ Accelerate revenue recovery while cutting administrative overhead Reducing denials means smoother operations and more time to focus on what truly matters—patient care. Let’s innovate revenue cycle management with AI-driven solutions. 𝗟𝗲𝗮𝗿𝗻 𝗵𝗼𝘄: https://lnkd.in/dGi5dpeU #RCM #AIinHealthcare #HealthcareInnovation #DenialManagement #RevenueCycle #HealthFAX #HealthTech #MedicalBilling #ClaimsManagement #HealthcareAI #ArtificialIntelligence #DigitalHealth #HealthcareOperations #MedicalClaims #AIForGood #DataDrivenCare #SmartHealthcare #HealthcareFinance #PatientCare #HealthDataAnalytics #FutureOfHealthcare #AIConsulting #MedicalTechnology #HealthcareEfficiency #RevenueOptimization Gauri Naik,, Ph.D. Ashwin Kotwaliwale MD PhD OptraHEALTH

Cigna and Aetna: Understanding Downcoding Practices in E/M Levels Recent shifts in Evaluation and Management (E/M) coding by major insurers, such as Cigna and Aetna, are significantly impacting healthcare providers. The practice of downcoding E/M levels by these insurers is leading to reduced reimbursement and increased administrative workload for providers. Cigna's Approach: Cigna is leveraging automation and artificial intelligence (AI) for claims reviews, particularly affecting primary care physicians who often experience downcoding of higher-level visits such as 99214 and 99215. Key concerns with Cigna's approach include AI-driven reviews flagging visits without thorough human oversight, especially impacting primary care providers managing complex patients. Aetna's Approach: In contrast, Aetna's downcoding strategy involves retrospective audits, leading to potential clawbacks for providers even after initial reimbursement. Providers face challenges with audit-heavy processes, where medical records are reviewed post-payment, potentially resulting in recoupments if documentation is deemed insufficient. Aetna's focus on Medicare Advantage plans and specialists billing frequent 99215 visits poses particular risks for providers. Providers grappling with downcoding issues in their practices may find solutions through consultation with CodeEMR. For more information please contact: Stratton.Douthat@scribeemr.com. #Downcoding #Aetna #Cigna

The RCM Shake-Up in 2025: What Every Healthcare Provider Must Know. Healthcare billing and Revenue Cycle Management (RCM) in the U.S. is going through one of its biggest shifts ever—and it’s happening right now. Here are the trends reshaping how providers get paid -AI-Driven Payers → Automated prior authorizations, real-time claim adjudication, and predictive denials. -Denials on the Rise → Many providers still face high first-submission denial rates due to coding errors + payer policy shifts. -Patient Responsibility is Growing → High-deductible plans = more patient collections, transparency, and digital payments required. -Value-Based Care Push → More reporting, bundled payments, and compliance requirements than ever before. At Bright Health Alliance (BHA), we see these not as obstacles but as opportunities. We’re helping practices and providers to: Leverage AI-enabled claim scrubbing & denial prediction. Build smarter denial-management workflows. Deliver transparent billing that patients actually understand. Stay regulation-ready for CMS changes, telehealth billing, and even ICD-11 discussions. The future of RCM isn’t just about faster billing. It’s about predictive, patient-centric, and compliance-driven growth. How is your practice preparing for these changes in 2025? Drop your thoughts in the comments—we’d love to exchange insights. #HealthcareConsulting #MedicalBilling #RevenueCycleManagement #HealthcareFinance #HealthcareInnovation #DenialManagement #ValueBasedCare #Telehealth #HealthcareRCM #HealthcareTechnology #HealthcareCompliance Bright Health Alliance

Patient Access: The Strategic Frontline of Hospital Revenue In today’s healthcare ecosystem, Patient Access is more than a department — it’s a strategic advantage. - Real-time eligibility and insurance verification - Automated prior authorization tracking - Denial prevention at the source Hospital administrators recognize that every denied claim represents a missed opportunity. By streamlining front-end processes, we enhance patient experience and protect revenue. At nobleserve, we assist hospitals in evolving through intelligent automation and seamless integration across EMR, EHR, RIS, and LIS systems. Together, we can build a future where access is effortless and revenue is resilient. #HospitalLeadership #RevenueCycleManagement #PatientAccess #DenialPrevention #HealthcareOperations #nobleserve #DigitalTransformation #HealthTech #nobleserve

Tech Mahindra and Abacus Insights have joined forces to help healthcare payers meet CMS-0057-F with confidence.   Together we are enabling: - Certified FHIR®-enabled interoperability - Proven healthcare transformation expertise - Scalable, long-term compliance readiness   The compliance clock is ticking. Let’s get you future ready.   Know More: https://lnkd.in/g5FK7qmB #ScaleAtSpeed #TechMahindra #AbacusInsights #HealthcareCompliance #HealthTech #CMS0057F

Healthcare Reform & Billing: Key Takeaways for RCM Professionals 📢 The evolving healthcare landscape is forcing RCM professionals to rethink billing and reimbursement strategies. Are you prepared?  📌 Key Takeaways for Billing & Reimbursement:  → Proactive compliance tracking to prevent costly penalties   → AI-driven claims automation to reduce rejections   → Stronger patient billing strategies to improve collections   → Denial management workflows for a stable revenue cycle  At AcceleRev Solutions, we provide advanced RCM solutions to help billing teams stay ahead of reforms, reduce denials, and secure faster payments. Let’s build a future-proof strategy! 🚀  #HealthcareReform #MedicalBilling #RCMSolutions #RevenueCycleManagement #PayerRegulations #HealthcareFinance #ClaimDenials #HealthcareFinance #RevenueCycle #MedicalBilling #RCMSolutions #HealthcareCompliance #BillingSolutions #DigitalHealth #MedTech #HealthcareEfficiency #HealthInnovation #RCMExperts #HealthcareManagement #HealthcareRevolution #InsuranceBilling #HealthcareTransformation #HealthcareInnovation #DigitalHealth #HealthTech #HealthcareTransformation #HealthcareAI #MedicalBilling #MedicalCoding #RevenueCycleManagement #MedicalBillingServices #BillingAndCoding #HealthcareCompliance #MedicalRegulations #InsuranceGuidelines #StateRegulations

Billing Gaps Are Costing Healthcare Providers More Than They Realize Late Prior Auth approvals. Missed claim follow-ups. Tiny coding errors that trigger denials. It all adds up and it’s avoidable.   At Health Square, we help healthcare organizations: → Accelerate Prior Authorizations so patients get care faster → Ensure clean claim submission for fewer delays → Turn denials into dollars If keeping revenue on track has become a constant headache, it’s time for a smarter approach.   👉 Book a FREE demo and see how we help providers stay ahead of denials and delays. . . . #RevenueCycleManagement #HealthcareFinance #MedicalBilling #PriorAuthorizations #DeniedClaims #HealthcareReimbursement #DigitalHealth #MedTech #RCMSolutions #AIinRCM #RevenueIntegrity #HealthcareOperations #HealthcareInnovation #RevenueCycle #HealthcareProviders #DenialManagement