Editorials by Jorie

An Artificial Intelligence Driven Approach to Improve Revenue Cycle Management

Healthcare organizations are exploring ways to leverage the power of artificial intelligence to automate manual and repetitive tasks in their revenue cycle management. The application of artificial intelligence and automation has potential to improve revenue cycle management. As artificial intelligence and automation continue to become about of our daily lives, the future of revenue cycle is bright.



Healthcare leaders see potential in artificial intelligence (AI) and have identified many uses of artificial intelligence in healthcare, including prior authorization. Prior authorizations, however, are just one example of the burdensome processes involved in a transaction-heavy part of the healthcare revenue cycle.


Revenue cycle management today faces numerous challenges such as high costs, denials, and payments that are outpaced by cost increases. Hospitals and health systems see a potential solution to some of these issues using artificial intelligence technology in revenue cycle management.


Lets examine the benefits of artificial intelligence for revenue cycle management and the adoption of disruptive technology in hospitals and health systems:

  • Hospital administrators can address a number of high-volume, repetitive, and mundane tasks with the help of automation. This allows hospitals to expand production at a much lower cost, thus freeing up resources that can then be re-invested into those tasks that require a more human touch such as empathy, creativity and complex thought.
  • According to a survey, providers can save $9.8 billion USD by automating key revenue cycle management functions.
  • Organizations can do few things differently with their revenue cycle staffing and strategy with the help of Artificial intelligence.
  • Artificial intelligence enables organizations to address workforce shortages
  • Talent retention is important in competitive markets. This can be done by using artificial intelligence, which enables hospitals to reward employees who are loyal to the company with more consequential roles, freeing them from tasks that can be carried out by automation.
  • Artificial intelligence enables healthcare organizations to be more strategic with the work they outsource.


Healthcare revenue cycles can be as complex as the organizations they serve. Constantly changing payer guidelines, human error, and fluctuating claim volumes make it a dauting task to keep up with all the factors that can lead to lost revenue.


The Potential of Artificial Intelligence for Optimizing Revenue Cycle Management


The revenue cycle is full of tagged data, which means values are codified to data points to indicate specific events. These values indicate certain events and can be used to evaluate attributes of patients' diagnoses, for instance. Artificial intelligence can hep improve the success rate of getting to the right outcome against any of these process steps.


Artificial intelligence has the capability to imitate intelligent human behavior by utilizing various algorithms that find patterns me plan future actions to create a positive outcome. By addressing revenue cycle management challenges, such as prior authorizations, claims status checks, and out-of-pocket costs estimates, Artificial Intelligence can streamline your operation while getting the information that needs human intervention at the right time.


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