Revenue cycle management (RCM) can be a tricky task for healthcare organizations. Certain elements of RCM in particular require more subject-matter expertise. According to a survey from AKASA, a leading healthcare artificial intelligence (AI) developer, coding, denials management, and prior authorization are among the most in-depth areas of RCM. Among AKASA’s survey respondents, who selected up to five options, 78.7% reported that denials management requires the most subject-matter expertise, followed by 50.1% for coding, and 49.7% for prior authorization. Respondents also deemed denials management the most time-consuming, followed by prior authorization and insurance follow-up.

Advanced machine learning and AI-powered automation are excellent tools for streamlining RCM tasks, which gives physicians the benefit of more efficient time-use and revenue savings. Considering the American College of Healthcare Executives’ finding of ongoing hospital staffing gaps, streamlining RCM tasks is essential for physicians, who are increasingly strapped for resources, despite a rising number of claims. According to Amy Raymond, vice president of revenue cycle operations at AKASA, to achieve revenue goals and maintain yield improvements, healthcare leaders must use automation and AI-driven solutions to ameliorate physician burnout, thus ensuring that healthcare providers can effectively do their jobs.

To significantly affect the industry, it would behoove healthcare organizations to automate repetitive work, such as claims status checks. This would allow health systems and hospitals to turn their focus toward where it is most necessary, such as RCM items necessitating revenue cycle expertise and human discernment. In a perfect world, automation and AI-powered solutions can manage the full range of tasks, from the most banal to the most intricate and complex, thereby providing optimal support for RCM teams.

Raymond notes that securing qualified and experienced revenue cycle staff is a challenging task, but there are ways in which healthcare organizations can tackle it. For example, hospitals can employ automation for more repetitive work. This helps free up time for junior staff to take part in training opportunities, thereby fleshing out their areas of expertise. It also affords experienced staff the time to give more attention to intricate claims that bring in more revenue. Overall, this strategy benefits individual healthcare employees and healthcare organizations as a whole, as it marries investment in career development with revenue improvements.