How AI in Optimizing Revenue Cycle Management Automation?

November 17, 2022  by  wpking   391

Optimizing Revenue Cycle Management Automation

Healthcare Leaders believe that Artificial Intelligence (AI) and Automation have the capability to transform the revenue cycle management process the way we think. Only a robust and durable revenue cycle automation solution is needed to handle all complexities involved in patient eligibility verification to the denial management process.

Healthcare provider needs several key steps to make their RCM Automation more durable and efficient.

Did Revenue Cycle Management Need Artificial Intelligence (AI)?

Yes, many healthcare providers agreed with the answer because the Revenue cycle management process is a repetitive process that includes denials management and missing authorizations. Automating repeated process like denial management and missing authorization will lead to time consumption, reduces human errors, improves productivity, and reduces resource costs.

This makes Practices staff focus on other high-level work and patients to increase the quality of their service and patient satisfaction.

Reduced Claim Denials thru Patient Matching:

Patient matching is comparing patient demographic details with the existing insurance database to avoid claim denials. Your practice may get benefits if you have a high percentage of denials due to patient matching errors.

According to an article published in the Journal of AHIMA, one way to avoid the claim denial problem is that physicians should ensure during the patient visits must use standardized nomenclature when entering demographic entry to EHR. You should enter all three parts of the Patient name (First, middle & last) with their Date of Birth (DOB) and Social Security Number (SSN) if possible.

Ways to Optimize Revenue Cycle Process:

Revenue Cycle management is the process of collecting payments from patients or third-party providers for using the services. In Healthcare, it is also known as the cycling of the money from the time of the patient visit till the payment received for the services rendered.

Top Tips to Optimize Revenue Cycle Management:

Reviewing Patient Accounts:

The first step is to review patient accounts that are past dues. To check patient accounts one should look out for terms and conditions, Insurance and payer contracts, and the reason behind the increase in Account Receivables. Once you identified, the past dues can take action on patients who have not paid their dues.

Automated Billing:

Implementing automation to your practice will save time and prevent errors in billing claims of services rendered. Previously, hospitals have followed some Revenue Cycle management optimization techniques when it comes to healthcare price transparency regulation.

How AI Benefits in Medical Coding Process:

The medical coding process is a complex one that involves multiple steps and parties working together. Implementing AI in medical coding will improve coding accuracy by providing valuable feedback that helps identify errors before it happens.

Medical Coding includes Billing Coders, Coder Assistants, and Data Entry Personnel who works with different type of information. Adding AI to this will work together to provide high coding accuracy and also reduce costs.

Also, practices should follow different strategies to optimize revenue cycle management to avoid revenue loss.

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