Features For Ai Platform In Revenue Cycle Management

By Author: Albert Brown
Total Articles: 76
Comment this article

Administrative processes account for about 30% of U.S. healthcare costs, which means that all areas of a patient encounter, from check-in to billing and claims, are potential targets to obtain greater efficiency.

In the past 20 years or so, computer-assisted coding (CAC) has become a fixture in healthcare organizations of all sizes. Its use of natural language processing (NLP) to analyze medical documents and identify key terms and phrases brings other advancements of automation and artificial intelligence (AI) into the revenue cycle management (RCM) process.

In coding, AI systems take out some of the guesswork by analyzing patient data – encounter and lab data, patient history, prescriptions, etc. – as well as free text. It can also play an important role in auditing prior to adjudication. Based on this trove of data, the system can draw inferences and conclusions on how a patient encounter should be coded.