April Wilson April Wilson

When AI Goes Dark: Downtime Planning for an Automated Revenue Cycle

Hospitals plan for EHR downtime and ransomware. Almost nobody plans for the day their revenue cycle AI stops working, or keeps running and gets worse without anyone noticing. Here's how leading health systems decide which AI tools need a continuity plan, who gets to pull the kill switch, and what to keep in reserve.

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April Wilson April Wilson

Should Patients Know When AI Is Calling About Their Bill?

Health systems are debating whether to tell patients when AI is involved in their care. Meanwhile, automated and AI voice calls about appointments, estimates, and balances are scaling fast. Here's what federal rules already require, where the gaps are, and how revenue cycle leaders can set a disclosure policy before a patient complaint sets it for them.

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April Wilson April Wilson

Every model was right. The bill was still wrong.

Health systems are building AI portfolios like a maze: one defensible decision at a time, with nobody checking whether the pieces agree. Here's what that costs, and the two-week exercise that surfaces it.

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April Wilson April Wilson

AI Cyberattacks on Hospitals Are a CFO Problem, Not an IT Problem

The AHA said this week that hospitals cannot afford to defend themselves against attackers using AI. Two AI companies immediately offered to help pay for it. Meanwhile a phishing campaign is wearing MyChart's name, and a new executive order exposed how little hospitals know about their own equipment. Here is what all of it does to your cash.

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April Wilson April Wilson

The Real Story Wasn’t Physician Burnout

Almost every headline about the new physician survey led with burnout. I read the whole thing twice, and burnout is not what these doctors are telling us. They are telling us they cannot give their patients the care they know how to give.

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April Wilson April Wilson

Two weeks of work in four hours, for seventy-five dollars

A Jefferson Health employee turned two weeks of work into four hours for $75 in AI tokens. Great trade, once. The trouble is that nobody has solved forecasting token spend, only 18% of the health systems scaling AI hardest can measure what it's returning, and most of that consumption isn't landing in revenue cycle expense at all. Which means your cost to collect is understated and you don't know by how much.

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April Wilson April Wilson

We're hiring for the technology and firing for the technology in the same fiscal year

Twenty-one health systems have named a chief AI officer. The healthcare jobs with the highest share of remote postings are coding specialist, utilization review nurse, care navigator, and Epic clinical analyst. Those are the same four jobs on every automation slide in America. We are building the 2030 org chart from the top down and the bottom out, and nobody is paying for the part in the middle.

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April Wilson April Wilson

No Surprises Act Arbitration Paid Providers $15 Billion Last Year. I Wouldn't Build a Budget on It.

Providers pulled roughly $15 billion out of No Surprises Act arbitration last year, up from $4.1 billion the year before, and they're winning 87 percent of determinations. I've been chewing on that win rate all week, because a number that high in an adversarial process isn't a competitive advantage. It's a signal the process is mispriced, and mispricings in healthcare payment don't last.

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April Wilson April Wilson

Medicare Just Asked Whether AI Should Change What a Doctor's Visit Is Worth

Most of the coverage of the 2027 Medicare rule stopped at the rate cut. Further in, past the tables, Medicare stops proposing things and starts asking questions. One of them: if technology does part of the work of a primary care visit, how much should the visit be worth? Nobody has asked that in a payment rule before, and it will matter more to your revenue cycle than the rate cut will.

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April Wilson April Wilson

I Forecast the Future of Revenue Cycle Management From a Travel Company. Here's Why That Makes Me Better At It.

I forecast the future of the revenue cycle from a travel company — no hospital in sight. That's not as strange as it sounds. The reason I can see where RCM is headed has little to do with being in healthcare and everything to do with no longer being buried alive in it. A piece about altitude, thinking time, and the industry that quietly steals both from the leaders who need them most.

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April Wilson April Wilson

The Enemy Is Us. And AI Won't Be the Hero.

We keep looking for someone to blame for rising healthcare costs, and we keep hoping AI will rescue us. After most of a career in the revenue cycle, I think both instincts are getting in the way of the work that actually moves the number. Here is why.

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