Boosting Healthcare Revenue: How Advanced Technologies are Revolutionizing Medical Billing (RCM)

Jun 3, 2024 | Blog

administrative executive looking at computer billing data

Professionals in the healthcare industry are primarily dedicated to patient well-being as their primary mission, but often struggle with administrative complexities. Medical billing, a crucial aspect of revenue cycle management (RCM), can be a time-consuming and error-prone process.

Thankfully, advancements in RCM technology are offering a much-needed improvement to healthcare operations, adding efficiency, accuracy, and a boost in profitability for healthcare practices.

Robotic Process Automation

One of the most exciting developments is Robotic Process Automation (RPA). These tireless, digital assistants handle repetitive tasks like data entry, claim submission, and insurance verification. They also automate payment posting and preauthorization management.

By automating administrative, mundane processes, RPA frees up valuable staff time for tasks that require human expertise, such as patient interaction and complex coding. This not only reduces administrative burden but also minimizes errors that can lead to claim denials and lost revenue.

Artificial Intelligence

Artificial Intelligence (AI) takes RCM a full leap further. AI algorithms can analyze vast amounts of data to identify patterns and trends. This allows healthcare practices to predict potential claim denials, prioritize accounts for follow-up, and even automate the appeals process.

AI-powered tools can also learn from historical data to suggest the most accurate medical codes for each service rendered, significantly reducing coding errors and maximizing reimbursements.

Machine Learning (ML)

Machine Learning (ML), a subset of AI, continuously learns and improves over time. ML algorithms used in RCM can analyze a practice’s billing history to identify areas for improvement. They can then recommend best practices, optimize workflows, and even personalize patient communication strategies. This data-driven approach ensures that healthcare practices are constantly adapting to the changing business of patient care.

The benefits of incorporating these advanced technologies into RCM are proven:

  • Increased Efficiency: Automation streamlines workflows, freeing staff for more strategic tasks.
  • Reduced Errors: AI and ML minimize coding errors and identify potential claim denials, leading to cleaner claims and fewer denials.
  • Improved Cash Flow: Faster claim processing and fewer denials result in faster reimbursements and improved cash flow.
  • Enhanced Patient Experience: Reduced administrative burden allows staff to dedicate more time to patients, leading to a better overall patient experience.
  • Data-Driven Decision Making: AI and ML provide valuable insights that empower healthcare practices to make informed business decisions.

Outsourcing RCM Operations to Access the Benefits of Newer Advanced Technology

While the advantages are clear, some practices might find it challenging to invest in these sophisticated technologies, including hiring and keeping an experienced team of IT professionals. That’s where outsourcing RCM operations makes the most sense.

By partnering with an expert, qualified RCM service provider, healthcare practices can gain access to advanced technologies without incurring the significant capital expenditure. These service companies invest heavily in RCM software and utilize a team of highly experienced professionals who are well-versed in the latest technologies.

Outsourcing RCM offers several advantages beyond technology access:

  • Reduced Costs: Outsourcing eliminates the need to hire and train dedicated RCM staff, reducing overhead costs.
  • Improved Expertise: RCM providers have extensive experience navigating complex regulations and coding requirements, ensuring accurate and efficient billing practices.
  • Scalability: Outsourcing allows healthcare practices to scale their RCM needs up or down as their patient volume fluctuates.
  • RCM Data Analytics: Access to practice analytics identifying measurable performance indicators helps executives make important improvements to the operation.
  • Increased Profitability: The combined benefits of reduced costs, increased efficiency, and fewer claim denials lead to improved profitability for healthcare practices.

Ultimately, the decision to in-house or outsource RCM depends on a practice’s specific needs and resources. However, the advantages of advanced technologies in RCM are undeniable. By embracing automation, AI, and ML, healthcare practices can streamline their billing processes, improve financial performance, and dedicate more time and resources to providing excellent patient care.

UnisLink Brings Advanced Technology into Every Practice for Improved Financial Performance

UnisLink works with practices to incorporate the latest RCM technology to automate processes and streamline operations for better financial performance. Our experienced team helps reduce medical coding errors, improve claims submissions, manage denials, increase patient collections, and ultimately improves profits.

Our Engage™ Analytics dashboards help leaders understand where their practice can improve at all levels of the operation. With our proprietary Intelligent Care Management System (iCMS™), providers engage easily with patients, identify gaps in care, mitigate risks, and help patients with chronic disease management.

Contact us to discuss this topic and learn more about how UnisLink can use the most advanced technology and expert RCM services to improve operations and profits at your practice.