Optimize Your Hospital’s Revenue Cycle for Efficient, Patient-Centered Operations
AHA Knowledge Exchange
Enhance critical KPIs via intelligent innovations using AI and automation
As hospitals and health systems prepare for 2025, reinforcing financial stability and cash flow in the face of rising costs, declining reimbursements and workforce challenges is top of mind. Health care leaders need full visibility into key performance indicators (KPIs) and the drivers of performance in revenue cycle management (RCM) outcomes to make informed decisions.
By reducing redundant tasks, artificial intelligence (AI) streamlines documentation and processes, which in turn can help lower denial rates and boost patient satisfaction. This Knowledge Exchange e-book examines KPIs vital for revenue-cycle outcomes and focuses on how AI and other advanced technologies may drive RCM improvements and the delivery of high-quality patient care.
9 ways health leaders are leveraging automation and AI to improve financial performance and service quality
- Establish a team to analyze denial patterns. Consider utilizing robotic process automation (RPA) to keep up with changing payer and plan policies that may result in denials.
- Reduce days in accounts receivable by using predictive modeling based on historical data from payer denials and scoring of accounts to assign work to teams.
- Reduce denials by using automation in the electronic health record (EHR) to identify appropriate coding for particular services, which can be shared with specialist providers.
- Use RPA to automate eligibility verification and registration processes in order to optimize workflows and operations.
- Consider AI functionality to efficiently create clinical documentation improvement alerts, which will help staff identify accounts and claims in need of additional clinical information.
- Implement computer-assisted coding to drive down “Discharged Not Final Billed” accounts and consider autonomous where feasible to alleviate coding staff shortages and allow coders to focus on more complex cases.
- Utilize AI and RPA to assist with drafting appeal letters in order to streamline steps and reduce administrative burden on staff and clinicians.
- Employ a payer scorecard with denial analytics and predictive modeling to assist in Joint Operating Committee (JOC) meetings with payers.
- Craft a patient-centric financial experience using AI to create a transparent and flexible billing experience.
Participants
Elizabeth Ackroyd, MBA, CPC
Senior Manager of Revenue Integrity
Sarasota Memorial Health Care System
Marley Blakeley
Vice President, Revenue Cycle Operations
R1
Jessica Cook
Patient Access Supervisor
Children’s Healthcare of Atlanta
Ruth Hauser, RHIA, CDIP, CHPC
Director, Health Information Management and Clinical Documentation Improvement
Children’s Hospital Los Angeles
Valarie Johnston, BSHA, CPC, CRCR
Director, Patient Financial Services
Bryan Medical Center
Kathie Kirkland, MBA
Director, Patient Financial Services
Henry Mayo Newhall Hospital
Lisa Maqueira
Vice President of Finance and Chief Revenue Cycle Officer
Cedars-Sinai
Moderator:
Suzanna Hoppszallern
Senior Editor, Center for Health Innovation
American Hospital Association
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