Introduction to Artificial Intelligence in Healthcare
Revenue cycle management software vendors are increasingly using artificial intelligence to help health systems improve their performance. This is particularly important for health systems of all sizes, from small regional systems to large multi-state systems, as they face increasing expenses and lower reimbursements.
Challenges Facing Health Systems
With expenses rising and reimbursements declining, health systems are looking for ways to improve their revenue cycle management. This includes fully utilizing operating rooms, appealing denied claims, and streamlining coding operations. Health systems operating on thin margins and with high administrative expenses need to find ways to drive growth and reduce their burden.
Driving Growth and Reducing Burden
West Tennessee Healthcare, a non-profit health system, has been able to increase its OR utilization using artificial intelligence scheduling software. The software matches independent surgical case requests to open spaces on operating room schedules, resulting in a 9% increase in orthopedic service line within the first 100 days. This has led to a fourfold return on investment, according to the software vendor, Qventus.
How AI Scheduling Software Works
The AI scheduling software uses machine learning to analyze scheduling requests across OR locations, enabling outside clinical schedulers to book surgical time. This has added 61 cases to the schedule in the first 100 days of use, an increase equaling 90% of the investment in AI.
Surfacing Reimbursement Potential
AdventHealth has used Iodine Software’s pre-billing software to analyze and prioritize patient records that AI predicts will have the most significant potential for reimbursement. The software directs the cases to review teams, excluding low-value cases and validating codes by identifying missing documentation. This has resulted in an average of 63% reduction in claims review times and a total reimbursement of $2.394 billion across more than 1,000 health systems.
Benefits of AI in Reimbursement
The use of AI in reimbursement has transformed the productivity and financial performance of health systems. By prioritizing the right cases, health systems can drive growth and reduce their burden.
Assisting Complex Coding
The Cleveland Clinic has partnered with Akasa to add machine learning processing to its revenue cycle operations. The health system reviews over 100 clinical documents per case, selecting codes from more than 140,000 options. The partnership aims to streamline and improve case review, enabling coders to utilize a coding AI assistant tool that supports comprehensive, efficient, and accurate practices.
How AI Coding Assistant Works
The AI coding assistant tool can read a clinical document in less than 2 seconds and process more than 100 documents in 1.5 minutes. This aims to bring greater efficiency and accuracy to complicated and time-consuming tasks, such as autonomous coding.
Conclusion
The use of artificial intelligence in healthcare is transforming the way health systems manage their revenue cycle. From AI scheduling software to AI coding assistant tools, health systems are finding ways to drive growth, reduce their burden, and improve their financial performance. As the healthcare industry continues to evolve, the use of AI is likely to play an increasingly important role in helping health systems operate more efficiently and effectively.
FAQs
- What is revenue cycle management in healthcare?
Revenue cycle management refers to the process of managing the financial aspects of healthcare, from patient registration to billing and reimbursement. - How can AI help health systems improve their revenue cycle management?
AI can help health systems improve their revenue cycle management by streamlining processes, reducing errors, and improving coding accuracy. - What are the benefits of using AI in healthcare revenue cycle management?
The benefits of using AI in healthcare revenue cycle management include improved financial performance, increased efficiency, and enhanced patient care. - How can health systems implement AI in their revenue cycle management operations?
Health systems can implement AI in their revenue cycle management operations by partnering with AI software vendors, such as Qventus, Iodine Software, and Akasa.
