Artificial intelligence is an alluring—or frightening—reality, depending on your point of view.
There are those who fear their job will be eliminated by machine learning and innovative computer systems, while others hope the computer wizardry will reduce their need for employees, resulting in a significant reduction in labor costs.
When you evaluate how artificial intelligence applies to healthcare, specifically patient access and the revenue cycle, it’s quickly obvious why the concept holds special appeal because nowhere in healthcare is there more frustration with efficiency. Hospitals spend a lot of resources to get paid what they’re owed so the idea they could streamline the process using artificial intelligence versus employees is intriguing, but what is the reality?
People vs. technologies
Many of the hospital leaders I speak to on a regular basis ask me about the potential of artificial intelligence to solve their patient access and revenue cycle challenges. They’re full of hope they will be able to utilize software featuring artificial intelligence to perform tasks that cost their employees time and the organization money.
Yes, using AI to automate the manual, repetitive tasks that bog down patient access improves the overall effectiveness of staff. When you can make your staff more efficient and scalable, it frees them to focus on higher value tasks and patient care. It’s a win for both patient and staff satisfaction.
But what the solution can’t do is magically eliminate the need for empowered registrars. Maximizing growth while improving efficiency requires both people and technologies.
From AI to IA (Intelligent Automation)
I didn’t invent this phrase, but I love it. Using artificial intelligence to remove people from the process of obtaining reimbursement is not possible, nor is it desirable in an industry that values the human connection in healing. So, what happens if you just flip the meaning? Instead, intelligent automation is viewed as an enhancement that can make the revenue cycle more efficient and accurate. This is possible through the use of automated tools that not only inform the people who are responsible for completing the many complex steps required to ensure payment, but also tools that train them to avoid costly mistakes.
When you successfully implement intelligent automation your patient access and revenue cycle tools will enable patient access teams to detect and correct errors and risks to revenue at the front end of patient engagement. This eliminates expensive rework, denials, collections and write-offs that surface later in the revenue cycle, while increasing pre-service payments and financial assistance conversions.
Many problems start at the front end, where manual processes at the initial patient encounter multiply through complex processes and create an unfavorable start to the patient financial experience. Instead of focusing on error-free registration, which can inform accurate payment estimates, many patient access teams are forced to focus on correcting bills retrospectively.
So, it’s true many registration and preregistration tasks can be automated, delegated to the patient and confirmed (and corrected) through an intelligent rules engine, but a real person still must make important decisions and relate well to the patient. Healthcare is a human need that requires the human touch. Often registrars provide that initial connection, setting the stage for the patient experience. With automated tools that establish work queues and prompts to fix errors at registration, registrars quickly know their work priorities and with an automated front end, they receive instant feedback they can act on immediately.
When your tools enable end-to-end automated prior authorization, self-service check-in and registration, virtual waiting rooms and intelligent eligibility and benefit validation capability, your revenue cycle becomes increasingly more efficient, reducing your need for additional labor, and allowing your existing team to work at the top of their capabilities.
So instead of thinking about automation as a replacement for the people who do the hard work of patient access and revenue cycle, think about it as synergistic. When people and automation work together, hospitals, health systems, employees and patients experience a better result.
Photo: sorbetto, Getty Images
