“The advance of technology is based on making it fit in so that you don’t really even notice it, so it’s part of everyday life.” – Bill Gates
For hospitals and health systems, integrating advanced technologies into their daily revenue cycle activities has gone from being a convenient luxury to a critical imperative. With unprecedented challenges dotting the healthcare RCM landscape – from a lack of qualified RCM employees to skyrocketing claim denials to elevated patient expectations – revenue recovery is as difficult as it’s ever been for healthcare organizations.
However, technology is proving to be a powerful equalizer.
RCM Technology: Use it or Lose a Lot
Artificial intelligence, robotic process automation (RPA), and predictive analytics have transformed healthcare RCM, giving healthcare organizations access to amazingly powerful tools that streamline operations, reduce the potential for human error, enhance the patient experience, and improve financial outcomes.
- AI automates repetitive, non-critical-thinking tasks at lightning speed. This efficiency allows experienced RCM staff to focus on more complex tasks.
- Conversational AI allows 24/7 interactions, enabling patients to access information and make payments on their own schedules. This not only increases cash flow (without requiring any after-hours staff) but also significantly improves overall patient engagement.
- RPA gives patients access to their own “concierge-style” payment process, which enhances the patient experience and increases the likelihood of a positive payment outcome. Research shows that patients want self-guided and live options throughout their billing process. RPA makes a completely autonomous experience possible, freeing high-level employees to work on more complicated tasks.
- Predictive analytics relies on machine learning algorithms that digest huge swaths of data, identify patterns, and make educated predictions about future outcomes. These “predictions” give providers an inside track to the patients with the highest propensity to pay their bills, which increases the probability of successful collection.
Predictive analytics also pinpoints insurance claims that are likely to be denied based on historical denial data. Tech-forward providers can identify dirty claims, fix any issues, and submit clean versions with a higher likelihood of success. The ability to flag and fix dirty claims before they go out the door is especially valuable today, since payers use AI to scrutinize and reject more claims than ever.
Integrated Technologies as a Force Multiplier
Each of these technologies is a powerful tool to assist healthcare organizations in specific areas of their revenue cycle pursuits. However, to truly maximize these technologies, they need to be integrated and used in a singular, cohesive RCM strategy. By leveraging AI, RPA, and predictive analytics at mission-critical junctures throughout the RCM workflow, healthcare organizations can benefit from an end-to-end revenue cycle solution that supports front-, middle-, and back-office RCM tasks. The speed and capacity of these integrated technologies mitigate a potential lack of qualified RCM employees for small and mid-sized organizations, while optimizing the time and functionality of existing staff.
Before Technology, a Change in Philosophy
As referenced earlier, hospitals today face a challenging financial landscape characterized by skyrocketing claim denials, exorbitant costs for care, and a lack of qualified RCM employees. While cutting costs is the standard, and seemingly logical approach for hospitals and health systems attempting to maintain a consistent stream of revenue, the emergence of AI and other technologies has made that philosophy outdated.
Instead, providers need to shift their mindset away from cutting salaries and services (especially RCM salaries) and focus on the long-term revenue-generating (and revenue-cycle-stabilizing) powers of RCM technology.
While cost-cutting measures may offer short-term relief, that relief likely pales in comparison to the revenue that stands to be recouped by AI and automation. By investing in technology and retaining RCM-related employees, healthcare organizations give themselves a much better chance to capture the revenue they’re owed and achieve long-term financial health. Of course, that’s easier said than done when financial pressures mount. However, based on the returns generated thus far, committing to tech-generated solutions appears to be the most viable path to better revenue cycle performance.
CONCLUSION
In today's complex financial landscape, healthcare organizations must maintain their resolve regarding revenue cycle performance. While investing in RCM technologies and personnel might seem counterintuitive when cash flow is stagnant and A/R is growing, recent history has shown that it’s the best long-term strategy for organizations that want to better control their financial futures and get off the hamster wheel of revenue recovery.
Utilizing a comprehensive suite of solutions, including AI, RPA, and predictive analytics, allows healthcare organizations to automate and execute repetitive tasks, mitigate insurance claim denials, reduce aging A/R, enhance the patient experience, and improve financial outcomes. In only a few years, the benefits of integrating RCM technologies have been remarkable and indisputable.
Of course, it should be noted that a truly complete RCM solution isn’t about technology alone. Along with a technology component, there remains a critical need for an experienced team of RCM experts to provide guidance and instruction, and to handle the more complex RCM tasks that technology can’t.
This is why joining forces with a proven RCM partner with a tech-powered RCM solution often emerges as the most sensible choice for healthcare organizations. By teaming up with an accomplished RCM partner that offers cutting-edge technology and an experienced team of industry experts already in place, providers can offload the intricacies of revenue cycle management and optimize revenue recovery while focusing on their core mission of delivering outstanding, patient-focused care.
At Meduit, we have combined technological innovation with healthcare-specific RCM expertise to create a complete revenue cycle solution for hospitals, health systems, and medical groups. Our solution maximizes AI, robotic process automation, predictive analytics, and more, along with a highly trained team of RCM experts to support patients throughout their financial experience and deliver the financial results our healthcare clients expect and deserve.
For more information about Meduit’s tech-powered RCM solution, contact us.