Applying AI to RCM: The Right Vendor is Integral to Success

Advancesinartificialintelligence(AI)andthehighlytransactionalnatureof revenuecyclemanagement(RCM)havesetthestageforAItoaddressmanyof RCM’sbiggestpainpoints,whileincreasingrevenuecaptureandhelping achieverevenueintegrity.

Whetherit’sautomatingmanualandredundanttaskswithinpatientaccessor billingorapplyingAItoreal-timeanalytics,priorauthorization,workflow prioritization/optimization,anddenialmitigation,thepotentialforAIinRCM isalreadybeingrealizedbyearlyadopters.

However,whenitcomestodeployinganyAIstrategy,selectingtheright technologyvendorcanmakeorbreaktheentireproject.

The Right Fit

ThebestAIvendorswillbethosethatnotonlyunderstandtheproblemAIis expectedtosolvebutarealsowillingandabletoanalyzetheprospective customer’sexistingoperationstoidentifyandaddressissuesinwaysthatfit wellwiththeorganization.Prospectivevendorpartnersshouldhaveaproven

trackrecordofrevenuecycleexpertisethatgoesbeyondasinglespecialtyto ensuretheyareabletoaddressallneeds.

Itisalsoimportantthatvendorsbringrealisticexpectationstothetable ratherthanover-promisingduringthesalesprocessandultimatelyunder deliveringoncethedealissigned.Honestperspectivesandachievablegoals areimperativetolong-termsuccess.

Prospectivepartnersshoulduseindustry-standardAItoolssuchasnatural languageprocessing(NLP)andknowledgegraphsandprovideconfigurable solutionsratherthanone-size-fits-all–whichiscrucialbecausenotevery platformisidealforeachcustomer.Additionally,end-to-endRCMcapabilities anddatastandardizationmustbepartofthedeal.

TherightvendorwillbetransparentabouttheviabilityofAIandautomation acrossalltasks.Therealityisthatthereareseveralcomplextasksand processeswithinRCMwherethesetechnologieshavenotyetreachedthe levelofmaturitytooperatefullyautonomously.Assuch,it’simportanttoseek outapartnerthatcanalsoaugmentinternalstaffwithhighlytrainedand educatedprofessionalservices.Thishybridapproachenableshealthcare organizationstoeasilyscaletheiroperationsbasedonchangingdemandsand volumes.

Finally,lookforavendorthatoffersacloud-basedplatformandprovides seamlessintegrationforasinglesourceofinsights.

Positioned for Success

SuccessfulintegrationofAIandautomationintotherevenuecyclestartswith understandingwhatcanbeexpectedofthesetechnologiesandevaluatingthe revenuecycledepartment’speople,processes,andcurrenttechnologiesto identifyaproperfit.Italsoinvolvesworkingwithhonestpartnerswhocan providetheknowledgeandsolutionsthatspecificallymeettheneedsofthe healthcareorganization.

Thus,takingthetimetovetanyprospectiveAIvendorfullyandcarefullyis criticaltoensuringthat,oncethetechnologyisinplace,itsimpactonRCMis optimizedtomeetthehealthcareorganization’sspecificanduniqueneeds.

Source of content: AGSHealth Blog- Applying AI to RCM: The Right Vendor is Integral to Success