Where LLMs Make Sense — and Where They Don’t
Understanding when to use an open reasoning model versus a deterministic or predictive system is the new systems-thinking challenge. … Read More
December 3, 2025
Insights
Ideas, insights + industry updates
Payer Trendscape 2025: 3 Trends to Track
Payers are reshaping hospital reimbursement at the expense of compliance + cash flow. We dig into the data + offer tips to boost performance. … Read More
November 13, 2025
The WISeR Model: Using AI in a New Era of Prior Authorizations for Medicare
The Wasteful and Inappropriate Service Reduction (WISeR) Model introduces prior auths for select services at risk of fraud, waste and abuse. … Read More
November 5, 2025
Ensemble Outperforms in Latest KLAS End-to-End RCM Report
Ensemble received the highest client satisfaction across all metrics and a top overall performance score of 95.1 on a 100-point scale. … Read More
September 11, 2025
Ensemble’s Always-On Management of Uninsured + Underinsured Populations
Ensemble treats underinsurance as a perpetual, complex challenge, not a one-off crisis. Our end-to-end model easily scales to the OBBA era. … Read More
August 14, 2025
The Two Midnight Rule
Dr. Khiet Trinh + Dr. Maria Johar explain the Medicare Two Midnight rule, demonstrating how to determine inpatient versus observation status. … Read More
July 24, 2025
What Is a Physician Advisor?
Dr. Khiet Trinh and Dr. Maria Johar explain the role of physician advisors in supporting clinicians with billing, status and denial issues. … Read More
July 24, 2025
Inside the RCM Model Outperforming the Industry
Don’t automate tasks; orchestrate the entire revenue cycle. Look inside the end-to-end model driving a 3% first-year revenue boost. … Read More
July 11, 2025
Cyber or System Downtime — Strategies for Staying Operational
Epic Business Continuity Access + an Incident Recovery Application strategy help maintain operations during an incident + recover afterward. … Read More
June 30, 2025
How We’re Addressing Patient Referral Leakage
By understanding the causes of referral leakage, we can develop strategies to mitigate it, ensuring patients receive coordinated care. … Read More
May 16, 2025