Artificial Intelligence
Photo: Getty Images

Revenue Cycle Management is the driving force in ensuring hospitals and healthcare facilities maintain a healthy balance sheet. Unfortunately, COVID has caused 86% of healthcare providers to see a decrease in revenue, according to a survey by HFMA.

President of TruBridge, Chris Fowler, stated in the survey report, “In general, the pandemic is magnifying two areas of deficiency. First, it’s showing many organizations that they have outdated business processes or products, or in some cases people who don’t have the correct training, tools or skills to perform in a largely remote environment. Second, it’s teaching organizations there’s a greater need to lean on technology to ensure they maximize revenue, especially related to self-pay cash collections and holding payers accountable for reimbursement that’s exactly aligned to contract terms.”

Artificial Intelligence

An emerging technology many providers can lean on is artificial intelligence. It can help in making the revenue cycle more efficient by providing valuable insights from historical data. At Data-Core Healthcare, artificial intelligence is used to evaluate healthcare claims prior to submission to predict the probability of denial. As a result, providers increase clean claim rates and provide quicker reimbursement.

A recent acquisition of Change Healthcare by Optum has highlighted the increased focus on artificial intelligence in the healthcare sector. Both Change Healthcare and Optum have been leaders in the healthcare technology space. The acquisition suggests that the two companies will put their technological capabilities together to improve “clinical, financial, administrative, and patient engagement outcomes.”

COVID has created a need for faster and more accurate processes within the revenue cycle. Artificial intelligence-based tools have the ability to automate previously manual processes. Data-Core Healthcare uses artificial intelligence to help automate the conversion of paper-based EOBs to electronic EDI-835 files. This solution decreases the need for manual intervention in the process, creating more accurate files at a quicker pace.

The use of artificial intelligence is the future of healthcare technology. It can decrease the time it takes to complete the tasks and increase reimbursement. Read more about Data-Core Healthcare’s Artificial Intelligence-based solutions here.