Remember the last time when you took an alternate route shown by Google Maps on a busy route? or when you received close and relevant recommendations on your shopping list or your personal assistants like Alexa or Siri. Artificial Intelligence (AI) is setting its foot prints in Revenue Cycle Management and is geared up to give a tough fight to the insurance companies who are already using AI to find ways to deny or underpay claims.

AI is making life better by adding brut force decision making, processing millions of claims to provide intelligent solutions, and automating manual jobs using complex algorithms. The question is how can AI optimize your revenue cycle management, reduce errors in your claims and help you grow your business. Before we dive into the technology let’s understand the challenges of healthcare industry and then take a closer look into the kind of results AI in RCM has to offer.

Your organization collects huge amount of data daily. From patient registration, documenting treatment procedure to billing – there is an ocean of information left for you to learn from mistakes and perform better. However, the challenge is older techniques try to improve searches, add speed and provide accurate results, but many times they fail to provide any improvement or predict things.

So, how do you read the tsunami of data, process it and extract meaningful information to make better decision and avoid denials? Or to put in other words, set your AI to fight against the Insurance AI. Yes, the future of RCM is going to be AI vs AI.

Using AI, you can tune your current processes and workflows to find patterns in huge amount of data by using complex algorithms to not only automate multiple tasks but also to perform in a way they are accurate. Through Natural Language Processing (NLP) AI can identify mistakes in your documents and suggest changes. Quality check which can take days manually can be done instantaneously with accuracy.

Let’s move to a more specific discussion on how AI can help you grow your healthcare business with its super intelligent tools:

• Cost Optimization: Revenue Cycle Management is a laborious job. You have to manually enter the details of every patient, write the code for the procedures and perform quality check. Operating costs go high as the number of patients increase and you need huge manpower to manage your revenue cycle. With AI and automation you can straight away reduce your operating expenses.
• Accuracy: With machines doing the tedious tasks of the populating data and quality check, you can be sure of an error free result. Human mind needs focus and attention to do a perfect job. When the job gets routine mistakes are normal, but can cost you millions. Application of AI can help you achieve high accuracy and also improve productivity.
• Identify patterns: AI can help you identify the latest changes in the rules of coding, billing or any other update in RCM. You can stay informed about the common mistakes in denials and optimize your accounts receivables.

At Promantra we continue to observe the application of AI in the industry and monitor the benefits from a user perspective. We have built various bots that can be integrated with existing PMS or EHRs being used to perform complex or repetitive tasks. We have successfully built bots to automate sub-processes in Revenue Cycle Management like Transcription, Coding, Billing, and most importantly AR & Denial Management. Using our AI tool - RevvPro, you can not only submit accurate claims but also predict how much you are going to get paid. Imagine avoiding getting into situations to get back to patient later to collect the co-pay versus getting paid upfront as you know exactly what your insurance reimbursement will be. This is one example out of the various benefits our AI tool - RevvPro provides.

If you are having challenges in managing your RCM, our healthcare experts at Promantra will be happy to explain you about the AI solutions we have to optimize the process.

Chirag Patel
VP - Corporate Communications
chiragb@promantra.us
Phone: +1-732-414-3678