Editorials by Jorie

The Healthcare Revenue Cycle is Being Revolutionized By AI and RPA

Artificial Intelligence and Machine Learning are quickly becoming the most common buzzwords in healthcare. The next logical question is when these emerging tools will start to be used by revenue cycle management organizations? The answer is today. Healthcare operations are undergoing a disruptive transformation due to automation, which is creating new capabilities in a variety of enterprise processes, from revenue cycle management to robotic process automation and artificial intelligence solutions.

Healthcare companies that want to optimize their revenue management are seeking visibility throughout their interconnected sales systems in order to locate where efficiency throughout  their revenue cycle management may be introduced. However, the collection of sales cycle facts is usually a slow, costly, and resource-intensive process.

The use of robotic process automation and artificial intelligence technologies - often called intelligent automation continues to be proven effective in automating manual, repetitive tasks, which can quickly generate benefits for many healthcare organizations. Intelligent automation allows you to create software bots than can learn, mimic, and execute rules-based processes the way staff would at some point in the sales control cycle.

Across the major phases of revenue cycle management - registration, coding, backend billing - several high-impact use cases emerge where RPA technology can reduce friction and ensure that necessary processes are completed on time and correctly. Healthcare providers lose $150 million annually due to missed appointments. Robotic process automation (RPA) bots can streamline appointment scheduling, registration, and claims.

An electronic health record (EHR) system largely dictates appointment scheduling, but it is not responsible for sending appointment reminders or initiating changes to other appointments and orders in the event of a cancellation. Robotic process automation performs these functions. Thousands of diagnostic and procedure codes are used to process claims, and inaccurate or improperly coded claims lead to denials requiring review, recoding, and refiling. This process wastes both time and money for payers.

The use of robotic process automation (RPA), which will ensure artificial intelligence development, can help organizations improve claim edit resolution and payment posting an reconciliation. Better management of accounts receivable allows organizations to speed cash flow and collect full payment. Healthcare organizations will be better equipped to whether the financial uncertainty caused by a pandemic if they empower their employees with revenue cycle management AI software, such as RPA and artificial intelligence. Adopting revenue cycle management software will enable providers to improve their revenue cycle and shift staff focus on activities that contribute to improved patient experience and outcomes, hallmarks of leading organizations as the healthcare industry increasingly looks to reward the value rather than volume of services provided to individuals and communities.

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