Every PM and EHR vendor is being asked about AI. Before committing to an AI denial prevention roadmap, here are five questions that should shape the answer.
August 27, 2026
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Every PM and EHR vendor is being asked about AI. Before committing to an AI denial prevention roadmap, here are five questions that should shape the answer.
PM vendor churn is rarely about the software. It is about the outcomes the software drives. First-pass acceptance rate is one of the most visible outcome metrics on that list.
Every PM vendor that has built payer connectivity in-house has, at some point, calculated its true cost. Most calculate wrong. Here is the math, with the hidden costs surfaced.
When your clearinghouse partner has an outage, your customers do not blame the clearinghouse. They blame your software. Here is what platform vendors need to know about partner brand risk.
HHS opened rulemaking on the next EDI standards migration in 2025. There is no deadline yet, but the last transition (4010 to 5010) touched every PM system in the market. Here is what to plan for.
The per-transaction rate your clearinghouse quotes is misleading. Here is why cost per patient is the only pricing comparison that matters, with the math worked out.
Portal-based claim submission works for a handful of payers. It breaks around payer 15 to 20. Here is what real multi-payer submission requires, and when platforms outgrow the portal approach.
Every PM and EHR platform eventually faces the build vs buy decision on payer connectivity. Here is a framework for evaluating both paths, including the hidden costs vendors rarely price in.
CMS rolled back some payer transparency requirements in 2025. With less public payer data available, the institutional knowledge your clearinghouse holds got more valuable, not less.
The CMS Claims Attachments Final Rule took effect May 26, 2026. Compliance is due in 2028. If you are still faxing documentation, here is what 18 months actually looks like.