Organizations are becoming more discerning in their implementation of revenue cycle technology solutions.
Now that AI has established its presence in revenue cycle management operations, leaders are eager to see the capabilities of the technology evolve.
Being able to aggregate information, automate tasks, and cross-reference data across different sources will foster the optimization and efficiency that executives want—and need—for their organization.
This is something Bill Arneson, director of business operational transformation at Moffitt Cancer Center and a member of the HealthLeaders Mastermind program on AI in Rev Cycle and Finance operations, is looking forward to seeing.
“I think this is going to amplify every person because the amount of time to do your work is just going to reduce,” he says.
This is something he’s seen in robotic process automation, where the tool is given a problem, the data, and guidelines to solve it.
“Cross-referencing and compiling all the information in such a short amount of time, that appeal would take someone hours to complete,” he said. “Whereas [we could] have someone review it, do a [quality analysis], ensure it’s accurate, and then submit it.”
AI and automation are used interchangeably in conversations around RCM, despite having different capabilities. For leaders, becoming more knowledgeable as the solution market continues to grow will help them know the difference and be able to specify what their organization needs.
It’s important for organizations to be specific in their conversations with vendors to make sure the technology has the capabilities they’re looking for.
“Get someone on your team or an advocate for you that understands the technology and let them question the vendors,” Arneson says. “Have an open technical conversation with no salespeople to get to the meat of the technology.”
Payers are equally interested in this technology, with even more resources to invest in them. As a result, they’re currently outpacing hospitals and health systems in digital expansion.
However, RCM executives are able to leverage different strategies alongside their RCM solutions, staff, and additional support from vendors.
“This kind of levels the playing field of allowing even smaller hospitals that can get on board with the vendor to get things going for them,” Arneson says. “This pays for itself very quickly if you start turning around denials because that’s real money you’re putting in the bank.”
Moffitt develops its RCM solutions in-house, as well as using vendor technology. A perk of having in-house developers, Arneson says, is being able to develop the staff and having the internal knowledge, without having to depend on a vendor.
While it does require more time and energy, it ultimately leads to a more secure and scalable environment.
Considering the popularity and growing use of AI and automated solutions in revenue cycle operations, organizations are becoming more discerning in their implementation.
Moffitt has a robust information security team that thoroughly reviews every vendor they work with and annually reviews all of the organization’s automated solutions to ensure they’re up to date.
“I think it’s the same principles that have always been there about network security, data security, password security,” he explains. “It’s just so amplified because every single piece now has a magnifying glass to it.”
The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Finance and AI Mastermind series features ideas, solutions, and insights on the current capabilities and future potential of RCM solutions in revenue cycle operations.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at [email protected]
Jasmyne Ray is the revenue cycle editor at HealthLeaders.
