How the "Big Beautiful Bill" Could Transform the Revenue Cycle for Healthcare Providers

The proposed “Big Beautiful Bill”—a sweeping legislative initiative championed by former President Donald Trump and now revived in his 2025 platform—aims to simplify healthcare billing and enhance transparency for patients. While the bill’s full text is still evolving, its central themes around price clarity, real-time billing, and AI-fueled automation signal major shifts ahead for revenue cycle operations across the country.

Here’s what healthcare facilities should understand—and prepare for.

1. Real-Time, All-Inclusive Pricing Means Front-End Overhaul

• What’s proposed: Patients will receive a single, clear, upfront estimate of their total cost—regardless of how many providers or services are involved. The bill seeks to mandate bundled pricing for common procedures and real-time benefits estimation.

• RCM Implication: Revenue cycle teams will need tighter integration with scheduling, clinical documentation, and payer systems to generate accurate estimates before service. This moves much of the work historically done on the back end (post-service) to the front end. Expect heavier reliance on automated eligibility tools, contract management systems, and benefits verification engines.

• Action Item: Audit your current pre-registration, price estimation, and financial clearance processes. Facilities not already investing in front-end financial engagement will face operational strain.

2. AI Is Moving from "Nice to Have" to "Required"

• What’s proposed: The bill includes provisions encouraging the use of AI to streamline billing and reduce administrative burden. This includes automated coding, claim validation, and denial prevention.

• RCM Implication: AI isn’t just buzz anymore. Facilities will be pushed—either by policy or competition—to adopt tools that can convert clinical documentation into coded claims, flag likely denials, and route tasks based on predicted reimbursement outcomes. AI will be used to reduce denials, shorten revenue cycle timelines, and support the “single bill” vision for patients.

• Action Item: Assess whether your EHR, clearinghouse, or billing vendor offers robust AI tools—or if third-party AI solutions can be layered on top. Coders and billers should be learning to work with AI, not against it.

3. Single Bill Mandates Will Pressure Collaboration Between Providers

• What’s proposed: A patient will receive one bill, not six—from imaging, labs, anesthesiology, and the hospital. Providers will be required to consolidate or coordinate billing under one umbrella.

• RCM Implication: Health systems will need to negotiate internal charge capture and distribution agreements—or outsource billing to centralized agencies. Independent providers that previously billed separately may have to enter joint billing arrangements, especially for bundled procedures.

• Action Item: Prepare for a more coordinated ecosystem. If you're a hospital or ASC, begin conversations with partner providers about unified billing workflows. Legal and financial frameworks will be key.

4. Denial Transparency and Appeal Timelines Will Tighten

• What’s proposed: Insurers will be held to stricter denial explanation standards and faster response times. Appeals must be acknowledged and resolved within specific timeframes.

• RCM Implication: Payers will face more pressure, but so will providers. Denial tracking, root cause analysis, and appeal documentation will need to be more standardized. Those without detailed audit trails and appeal automation may fall behind.

• Action Item: Ensure your denial management team is equipped with the right reporting tools and templates. If appeals are largely manual today, consider automation or third-party RCM partners to streamline workflows.

5. Patient Consent and Cost Acknowledgement Become a Compliance Risk

• What’s proposed: Patients must receive and acknowledge expected costs prior to care, or providers may lose billing rights for that encounter.

• RCM Implication: Failure to obtain clear cost acknowledgments could translate to lost revenue or even regulatory fines. This increases the need for integrated patient engagement platforms—text/email estimates, eSignature capabilities, and EHR-connected consents.

• Action Item: Update your intake and registration processes to include electronic cost acknowledgment workflows and proper documentation capture. Integration with your patient portal or EHR is essential.

Conclusion: The Future of RCM is Proactive, Predictive, and Patient-Centered

The “Big Beautiful Bill” is a shot across the bow for legacy RCM models. Whether all provisions become law or not, the direction is clear: transparency, simplification, and digitization are no longer optional. Facilities that wait to adapt until mandates are enforced will face steep operational and financial headwinds.