Applying AI, Automation to the Healthcare Revenue Cycle

Applying AI, Automation to the Healthcare Revenue Cycle

Inefficiencies in the healthcare revenue cycle represent opportunities to apply Artificial intelligence and automation when approached thoughtfully.


Artificial Intelligence (AI) and intelligent automation, in general, are changing the face of modern business, and this is as true in the world of healthcare as anywhere else. You may have at least a general understanding of how intelligent automation can benefit your healthcare business, but identifying the best use cases and defining a pragmatic action plan can be difficult.

Here are steps to assist healthcare professionals in identifying and implementing the best use cases for artificial intelligence within the revenue cycle processes of their organization.


The first step in getting started with automation is understanding the technologies available to you at a high level. There are two core types of intelligent automation available: AI and Robotic Process Automation (RPA).

AI learns and iterates as it goes by completing repetitive, high-volume, error-prone tasks while collecting intelligence on this work along the way. This approach allows the technology to ultimately identify and address larger, more complex, opportunities for automation. The goal of AI is to mimic human intelligence using computers, enabling them to solve complex problems quickly and to scale.

On the other hand, RPA simply takes a set of inputs and produces an output based on a predefined set of rules. RPA doesn’t “learn”— it reacts the same way every time. RPA can complete the same types of repetitive, high-volume, error-prone tasks while collecting simple metrics for reporting.

Regardless of the technology, the objective of intelligent automation in healthcare, or any other industry, is the same. Take repetitive, high-volume tasks that are done in a similar way every time and offload them to software, freeing up human capital to focus on more important tasks.

Human capital is often reduced to the number of hours human employees spend completing their work, but that view has to be expanded to truly see the impact intelligent automation can have on your organization. At the surface, using automation to replace repetitive tasks humans complete can save money — bots don’t require benefits or vacation time — and reduce errors because typos don’t exist in their world. But at a deeper level, automation can free up your human employees to focus on more complex skills, like customer service, patient advocacy, and empathy.

There are several forms of intelligent automation that offer a multitude of capabilities, but humans possess infinite intelligent skills. When you’re able to apply your staff’s skills to the most important parts of your business rather than to the processes that automation can conduct, that is when you truly see the value intelligent automation can bring to your healthcare organization.


With an understanding of AI and RPA, you can start to see where their applications lie. Rule-based business processes (e.g., insurance verification, data recording) are prime candidates for RPA. More complex judgment-based processes (e.g., eligibility checks that require a review of electronic health records) can benefit from the application of AI.

Categorizing your revenue cycle processes can help set the tone as you continue to brainstorm precise processes to automate and what that implementation should look like. Keeping that constant throughout your brainstorming helps solidify your choices.


The next step is brainstorming, identifying specific processes in your business that can benefit. As you begin to approach specific use cases for intelligent automation within your healthcare organization, it is important to consider the impact automation can have and the speed with which these tasks can be completed with automation versus how they are done now.

There are several common places impact and speed can be targeted within the revenue cycle, and account updates are usually a great place to start. These kinds of updates are usually a massive undertaking and can touch many or all of your organization’s patient accounts, and are tedious tasks that have to be done correctly.

Impact is immediately recognizable as automation is much faster than humans, reduces errors to negligible numbers, and can prevent costly errors down the line, saving your organization money. In this kind of automation, speed and impact are intertwined.


To identify specific processes to offload to intelligent automation, you can use either a problem or solution-oriented approach.

The problem-oriented approach looks to identify bottlenecks and areas where employees spend the bulk of their time performing repetitive tasks. The solution-oriented approach looks to optimize workflows and makes sense when there are no clear bottlenecks. This approach identifies where key performance indicators (KPIs) can be positively impacted by implementing intelligent automation. Whichever approach you take at this stage, remember that every moving piece in a healthcare business has multiple high-volume administrative processes. Intelligent automation does not have to be limited to one department or team — everyone can reap the benefits directly by improving their daily work, or indirectly by experiencing the positive impacts of these improvements in other tangent workflows and cycles.


Once you have identified where AI should be applied, you have to consider how you’ll get it implemented. Building an automation solution requires a team of highly skilled developers, project managers, and automation engineers. The DIY approach can make sense, but for many, the upfront costs and lack of technical knowledge create barriers. Partnering with an AIaaS provider makes the benefits of intelligent automation more easily accessible to businesses of all sizes and allows you to focus on core business competencies, instead of development.

Want to get started?

To take the first steps toward automation at your organization, download this free guide. You’ll learn how to identify the right processes for automation, and start to build the case for AI and automation.

The Importance Of Healthcare Data Security

The Importance Of Healthcare Data Security

Cyberattacks, data breaches, and hacking are key concerns for healthcare executives and a growing problem in the industry. A recent report showed that data breaches were up in 2018, with 503 incidents impacting almost 15.1 million patient records, compared to 477 breaches impacting 5.6 million records in 2017.¹  As hackers get more sophisticated, hospitals need to be increasingly vigilant about their healthcare IT and cybersecurity practices.

Healthcare data security is about more than just regulatory compliance: it needs to be central to a hospital’s ‘patient first’ focus, as it’s critical in maintaining consumer trust and organizational health. 

As anyone who has ever had their financial data stolen can attest, it can be a frustrating, costly, and time-consuming issue to correct. Credit card numbers must be changed, false charges corrected, and checks blocked. But unlike financial data, medical data cannot be corrected. Medical data is personal and can’t be changed or “wiped clean” – once the information is breached, the damage is done. Identity theft, insurance fraud, and extortion are all possibilities after a healthcare data breach, especially when you consider the medical information of CEOs, public figures, and other individuals are key targets for hackers on the black market. 

For hospitals or other healthcare systems, a breach can be financially devastating long-term, too. The service interruptions and potential HIPAA fines sting upfront, but lack of consumer confidence driving patients elsewhere could mean lost revenue for years to come. Overcoming a serious data breach requires extensive image and trust rebuilding in a community, usually in the form of a massive and expensive PR campaign. For these reasons, most hospitals already understand the significant risks involved when handling patient health information – a recent HIMSS survey showed that cybersecurity, privacy, and security are top concerns in healthcare.²

Unfortunately, concern about data security doesn’t always lead to action. 

Despite data security growing in importance, a 2017 Black Book Market Research survey showed that only 15% of organizations reported having a chief information security officer.³  Given the enormous amount of private information hospitals have access to, high employee turnover rates, and the lack of IT leadership, this only adds to the unique challenges healthcare organizations face when implementing cybersecurity measures – many driven by the large number of systems and software vendors that every hospital uses to coordinate care and manage their business. 

The sheer number of disparate IT systems used in healthcare is perhaps unrivaled in any other industry. Every system, every vendor, every connection, and every employee with access and responsibility for transferring sensitive data is a cybersecurity risk. That’s because EMRs and other healthcare interfaces weren’t built to share data – they were built as fortresses to protect the data of patients and to make sure that data was available only within the walls of that system. 

“The ‘walled fortress’ approach to security no longer works,” says Olive Chief Product Officer David Landreman. “Keeping all data within your physical facility is not the end-all of protecting your data, it doesn’t account for human negligence, and it doesn’t make up for a comprehensive approach to security.”

Instead, data must be exchanged seamlessly and securely in order for healthcare organizations to provide better care to people globally, and this can only be achieved through technology.

Technology vendors should be an area of scrutiny for healthcare organizations looking to mitigate risk. 

Implementing data protection strategies and vetting technology vendors thoroughly will enable healthcare organizations to meet regulations and share critical patient data more securely. To limit risk and improve overall IT security strategy, hospitals should perform a security assessment of the vendors they currently use to understand their risk. Every new vendor selection process should weigh security concerns heavily in the evaluation criteria – begin this security evaluation early to ensure your solutions are built with the complexities of your organization in mind.

What happens when a hospital conducts a security assessment and finds that a vendor isn’t measuring up? Hospitals have two real options: put pressure on the company to improve security or switch vendors. As anyone who has switched vendors or implemented new software knows, neither are an easy task. Possible contract cancellation fees, time spent evaluating new solutions, resources spent on re-training employees on new software – it all adds up. 

And what’s the incentive for current vendors to improve security practices if only 10% of their customer base, for instance, needs those security updates – does the cost of potentially losing customers outweigh the cost of upgrading cybersecurity? As mentioned before, switching vendors can be cost-prohibitive, leading many hospitals to stay with current vendors with only vague promises or extended timelines for upgraded security.

Working exclusively with healthcare-specific vendors reduces risk.

When new regulations come out, new medical devices emerge, and new threats develop in healthcare, hospitals need partners that understand their industry-specific needs. Healthcare-only vendors understand the unique challenges facing the industry and will be better positioned to address organizations’ changing needs – especially those around cybersecurity.


That’s why at Olive, we’re healthcare first, and healthcare only. 

Unlike other AI solutions on the market, Olive uses her healthcare-specific skills to address common bottlenecks when it comes to automating workflows – most importantly, she does it with unrivaled security measures built for healthcare, working seamlessly within common industry processes and your current IT infrastructure. Instead of adding to your tech stack, Olive helps you run the tools you already have in place more efficiently, handling sensitive data without compromising security, helping to mitigate hospitals’ risk. 

Olive was built from the ground up with the complexities of healthcare data in mind, working seamlessly with the security controls and practices healthcare organizations already have without compromising sensitive health information. We believe industry regulations like HIPAA privacy rules, SOC2 compliance and other bot-related compliance issues should be the least of your team’s worries – we want them focused on more human-like initiatives, like patient care.

Olive automates a variety of healthcare workflows with speed and ease because she was designed to interact with EMRs, insurance portals, and other healthcare applications the same way a human would – only faster, smarter, and more securely. And Olive’s capabilities around industry languages and standards were built specifically for healthcare – that means she’s experienced with HL7 standards (including FHIR), EDI X12 messaging, and more.

Are your current vendors providing the security your organization needs? Contact us today to learn more about how Olive can help your organization limit risk and improve your overall data security.






5 Innovations Moving Care Out Of The Hospital

5 Innovations Moving Care Out Of The Hospital

For years now, care has continued to shift out of the hospital to various, lower cost sites of care. A recent study even projected a 2% decline in inpatient discharges over the next 10 years while they forecast 15% growth in outpatient volumes.¹  Surgery centers, hospital outpatient departments, telemedicine, walk-in clinics, and home health care all continue to grow, driven by consumers’ demand for convenience, advancing technologies, and health systems and payers’ need to lower costs. 

At Olive, this shift in care is especially exciting as it will help improve the quality and quantity of life for many Americans across the country. Alongside technologies like artificial intelligence, process automation, and other emerging technologies, these advances help make care more affordable and accessible to all. 

Let’s look at some of the new innovations that are helping healthcare providers care for patients out of the hospital:


Improved Surgical Techniques

While it’s not a new innovation, continued surgical and anesthesia improvements have allowed more procedures to move from inpatient to outpatient settings. Surgeries that once required long hospital recoveries are now able to be done in Ambulatory Surgical Centers (ASC), office-based surgical practices, and Hospital Outpatient Departments (HOPD). 

Examples of surgeries that have been able to transition to out of home facilities are spine fusions and disc replacements, total joint replacements, retina procedures and more. Even cardiovascular procedures are beginning to move out of the hospital.

A study performed by the Ambulatory Surgery Center Association found that Medicare would save over $2.4 billion per year if half the eligible surgical procedures shifted to the ASC setting (as opposed to taking place in a HOPD).² And with the ongoing success of these surgeries in other settings, CMS has begun removing procedures from its in-patient only list, such as knee replacements, which will help speed up the shift to other sites of care.

Telemedicine Appointments

Remote doctor visits, commonly known as telemedicine, have increased tremendously in recent years, but there’s still room for continued growth. Telemedicine’s potential is largely due to improved communication technologies. Studies show that 77% of U.S. adults now have a smartphone. And with more access, higher-resolution video capabilities, and better security, doctors are able to have meaningful conversations and evaluations via video. This innovation is particularly important in rural areas where patients often have to drive hours to be seen by a provider.

While still mostly used for common illnesses such as pink eye, rashes, or an ear infection, telemedicine also has the potential to reduce readmissions, especially when combined with other technologies such as remote patient monitoring.


Remote Patient Monitoring

Remote patient monitoring (RPM) is a key piece of technology that will help telemedicine reach its full potential. RPM uses at-home sensors or tests to remotely transmit health data to healthcare professionals, where it is reviewed to detect potential health problems. 

RPM is especially important for managing chronic conditions, which affect six in ten American adults.4 Due to the high number and costs of visits required to monitor these patients, many routinely miss appointments and do not do schedule proper follow-up care. With RPM, these patients can be monitored more regularly without the burden of having as many in-person visits. The data can also identify potential problems so intervention can occur sooner, improving outcomes.

RPM is already being used for people with diabetes, heart failure, atrial fibrillation, pacemakers, and women with hypertension during pregnancy. But with new developments in consumer wearables and wireless technology, the possibilities of RPM will surely expand.

Remote Lab Tests

We’ve already seen direct-to-consumer sites like 23andMe and EverlyWell begin offering genetic testing and panels for thyroid, hormones, and food sensitivities. These companies send a testing box requiring the consumer to send back blood, saliva, or urine that is then analyzed at the company lab. 

Although these aren’t in the same category as actual health care at the moment, they are a glimpse into what could be possible in the future, as companies have proven that there is a demand for at-home testing options. They have also paved the way for improved testing by making consumers more comfortable with the idea of having lab work done at home. Currently, telemedicine companies are looking to add lab services to their offerings, for example an at-home test kit for strep throat or UTIs.

In the meantime, home health care patients are already benefiting from more sophisticated remote lab testing. For example, LabCorp’s Lab-in-a-Box and Lab-in-an-Envelope offerings allow home health care providers to collect blood samples for a variety of tests at the patient’s home and send to LabCorp via FedEx.


At-Home Care

There has also been a growing interest in more at-home primary care, especially for patients with severe chronic conditions who have trouble leaving the home. These patients are often the highest users of healthcare services, but their limited mobility makes it difficult to see a doctor regularly. Instead, they often resort to using ambulances and emergency rooms to access care. Because of these factors, this patient group has extremely high rates of hospitalization and hospital readmission.

Similarly to telemedicine, primary care house calls for those with chronic conditions could help manage these conditions better and preemptively identify problems sooner, leading to lower rates of hospitalization. It’s a shift towards prevention-based care instead of intervention, and so far, the numbers appear to support this approach. In the Independence at Home Project, 17 practices providing home-based primary care all saw reduced ER visits, hospitalizations, and 30-day readmissions during the five-year project period.5

There are also companies looking to bring urgent-care type services to the home, such as Heal. Their app enables physician house calls for conditions commonly treated at the emergency department or urgent care, such as sprains and ear infections. On another front, Mercy Care and Philips have teamed up for a pilot study with seniors that can provide home health care for urgent care using the Lifeline medical alert system. The program is trying to reduce readmissions and improve patient quality of life. As programs and companies such as these continue to emerge, it seems likely that more and more care will take place at home.

The Future Potential

It’s exciting to see innovations happening in the medical field, especially in the other sites of care. And as the industry as a whole moves to value-based care and preventive medicine, these fields become increasingly more important to connecting the entire continuum of care. We’ve already seen hospitals building, acquiring, and partnering with ASCs, outpatient facilities, and home health providers, which leads to an interesting question about the future: how can all of these points of care help integrate care for the patient and the providers to improve care?

Connecting health at home to the hospital and every other point of care in between is a huge opportunity for consumers and providers alike – it would improve engagement, cost, and outcomes. As patient care continues to move to a broader set of care sites, the need for interoperability will increase, as well – an area where many emerging technologies like operational AI will have an enormous impact. Together, AI and the data provided by home health providers and remote patient monitoring devices could hold the key to unlocking health and wellness insights that will improve care for everyone.



Cost Containment is a Top Priority in 2019 For Healthcare Executives

Cost Containment is a Top Priority in 2019 For Healthcare Executives


In the past few years, healthcare annual expenses have continued to outpace revenue growth, spurring increased interest in cost containment strategies from hospital leaders across the country. And in 2018, The Advisory Board’s Annual Health Care CEO Survey even found that cost control had jumped to the number one priority for healthcare executives as reimbursement dollars continue to shrink. 

During the 2019 Annual Becker’s Hospital Meeting, the Olive team heard leading healthcare executives discuss how rising costs are forcing their organizations to drive greater efficiencies with the same level of resources – all while organizations manage increasing complexity and dwindling reimbursement rates.

So, where can healthcare organizations have the biggest impact on cost containment as they plan for the future?

Today, many traditional cost containment strategies have focused on cutting overhead like human capital, facility, and supply chain costs. But supply and facility costs can only be cut so far, and cutting wages and employee hours is short-sighted, as these strategies contribute to employee burnout and increasing staff turnover rates across the industry. 

If hospitals truly want to reduce waste and contain costs, they need to look to the real source of the problem: operational inefficiencies.

Operational Inefficiencies Are The Leading Cause Of Waste

One out of every three dollars spent on healthcare each year is spent on the repetitive, high-volume tasks that make up the administrative side of healthcare. Increasing regulatory requirements are only adding to the burden – an American Hospital Association study found that an average size hospital today dedicates 59 full time employees to regulatory compliance alone, over a quarter of which are clinical staff. 

Interacting with health insurance plans is also puts pressure on a hospital’s time and resources – from authorizations, formularies, claims and billing, credentialing, contracting, and data quality review, the process is time-consuming and requires many manual steps that are prone to costly errors. Today, flaws in registration and eligibility processes are cited as the primary cause of insurance claim denials – an analysis found that $262 billion of the estimated $3 trillion in claims were initially denied due to errors, translating to an average hospital risking $4.9 million of lost revenues. 

As operational inefficiencies continue to drain valuable resources, it’s easy to see that the never-ending flux of data entry comes at cost – an even bigger cost when you consider the expense of re-work.

At the heart of these process inefficiencies is the lack of interoperability between systems. Data has to be manually pulled and entered from one screen to another, over and over again, making human error inevitable. And with increasingly complex regulatory needs and requirements, an overhaul of the entire system is far-fetched. Hospitals need solutions that work with the systems and processes they already have in place – and this is where organizations have a tremendous opportunity to create financial impact with artificial intelligence. 


How Artificial intelligence is Tackling The Problem

Artificial intelligence and robotic process automation have gone from a futuristic buzzwords to real-world solutions providing enormous value at health systems across the country. And while the innovative technologies are being explored for multiple areas, from AI-assisted surgeries to diagnostics, they’re uniquely positioned to solve many of the administrative flaws and headaches that cause so much waste.

Experts anticipate AI for the Healthcare IT market to surpass $1.7 billion by the end of 2019, and through AI and automation, healthcare systems have already begun to reduce expenses and increase revenue recognition. In turn, they’ve been able to take an impact-driven approach to AI implementation, providing both immediate and long-term value to their organizations.

Olive deploys a digital workforce to “shift” these operational inefficiencies from healthcare employees to artificial intelligence as a cost containment strategy. A digital workforce provides operational AI to improve the cost, capacity, and efficiency of administrative business processes by alongside healthcare employees to handle the large amounts of data and repetitive tasks that are draining the industry of resources and revenue. 

Olive saves healthcare organizations time and money by automating some of the most common process bottlenecks like claim status checks, prior authorizations, eligibility verification and more. She has a proven track record of working down massive backlogs of work, allowing organizations to really “catch up” on critical processes, reducing the expense of hiring more (and more) people to handle the work. 

Olive is trained to emulate all of the manual steps associates do – only smarter, faster and more accurately –  reducing costly errors and increasing operational efficiency. Best of all? Our AI-as-a-Service model means there is one simple subscription price and an all-in-one approach to implementing AI, so hospitals can quickly see a positive ROI

To learn more about Olive and how to hire a digital workforce, schedule a demo with us today.

How Burnout is Killing The Healthcare Industry

How Burnout is Killing The Healthcare Industry

Many healthcare leaders today know that labor is the leading cost driver in the industry – the cost of healthcare staff turnover is estimated to be 38% of annual salary expense per employee. And as labor continues to be many organizations biggest expense, employee retention is a critical component to the financial success of any healthcare organization.
But with the industry’s frustrating lack of interoperability, employees have taken on the job of the data processor, shifting the hours spent by employees from being in front of patients, to being in front of computer screens, logged in to disparate EMRs, EHRs and other interfaces shepherding patient data into the right fields. The consequences have manifested in the form of burnt-out employees, skyrocketing administrative costs, and less time spent with each patient – but how big is the problem, and how can we work to solve it?

  • Employee burnout is growing: studies show that nearly three quarters of healthcare leaders report feeling burned out.¹
  • Employee loyalty is fading: 37% plan to leave their current hospital within the next two years and almost 69% plan to leave within five years.²
  • Burnout is increasing turnover: Average turnover rate in healthcare is 20% and has risen nearly 5% – across all jobs in the industry – over the last decade.³
As this trend continues to grow, it’s no question that employee burnout and staff turnover come with a hefty price tag. The yearly hard dollar cost to recruit and train employees is already high, but when you add in the soft costs, you start to really see the bigger implications – it lowers morale and productivity, which in turn impacts patient care and patient outcomes. Additionally, costly staffing gaps put more pressure on the remaining employees, causing the problem to grow and compound.

Because of these issues, the average hospital has turned over 85.2% of its workforce since 2013, and with 31% of hospitals struggling to find candidates to fill open positions5, solving this growing problem is a top priority for healthcare organizations. To combat these challenges, health systems need a multi-faceted employee retention strategy – one that includes the expected perks like great compensation, benefits, and opportunities for advancement – but most importantly, one that addresses the root of the problem: process inefficiencies that are bogging down healthcare workers across the entire continuum of care.

In healthcare today, employees are suffering a “death by a thousand clicks6” because most hospitals use 10 or more various EHRs, EMRs and other user interfaces, sending employees toggling back and forth between various screens, playing “button Olympics.” 

Aside from being stressful and burdensome to healthcare employees, these administrative inefficiencies result in a trillion dollar spend across the industry.

Working to reduce this burden has a huge impact on a hospital’s bottom line, but retaining top industry talent goes far beyond the numbers. A solid employee retention strategy needs to also consider factors like employee engagement and opportunities to do more meaningful work – this is where organizations have a tremendous opportunity to create both financial impact and increased employee satisfaction with artificial intelligence. 

Artificial intelligence can take robotic tasks off the employee’s to-do list, allowing them to focus on higher-level tasks and initiatives. For front line staff, this means more time to spend with patients, which improves the patient experience and employee satisfaction. For back-office staff, this means more time spent on strategic initiatives and problem-solving, instead of mundane manual data entry.

Innovative health systems across the country are already using artificial intelligence and robotic process automation to alleviate employee burnout and staff turnover. And at Olive, we’re deploying a digital workforce to help “shift” these burdensome workflows from stressed healthcare employees to artificial intelligence. Olive is not another platform, another software, or another process to learn – Olive is the first digital employee built specifically for healthcare to replicate the robotic functions of a human employee, so healthcare employees can focus on more human-like initiatives.

“With Olive, we were able to reallocate 20 full-time employees to meaningful work, not the hours spent in front of their screens. There were no layoffs because there was so much work to do in the billing office that we just weren’t getting to before. Now these employees handle more fulfilling, complex tasks that require a human touch, and Olive takes the robotic workflows.” -Senior Director or Revenue Cycle, Midwestern Hospital

As your organization tackles the growing burnout that’s crushing the healthcare industry today, ask yourself these questions: What could your hospital do with more time? How many employees could Olive help focus on more meaningful work? How would those changes impact employee satisfaction and staff turnover at your organization? What would the financial impact be to your bottom line?

View our recent case study to see how Olive transformed this hospital’s administrative operations, allowing their employees to focus on higher-value initiatives that boost morale, patient outcomes, and overall revenue recognition.