AI is transforming revenue cycle in hospitals. Are physician practices next?

In the past few years, hospital adoption of artificial intelligence technologies has expanded rapidly, from assisting in cancer screenings to tackling the healthcare revenue cycle. It has changed from a futuristic technology to tangible solutions that can reduce costs and increase efficiency in healthcare. But so far, it hasn’t yet made its way into smaller, independent clinics and physician practices. 

AI is a big, transformative technology — but that doesn’t mean that it needs a big budget or a big IT department to implement. Today, artificial intelligence is moving into physician practices with solutions scaled to fit their size and address their unique needs. 

AI will help physician practices lower costs and increase efficiency

Overhead costs are increasing and reimbursements declining, eating away at physician practices’ profitability. To survive in today’s environment, leaders need innovative solutions to cut costs and increase efficiency in their practices, without compromising patient care. Artificial intelligence is that solution. When implemented wisely, artificial intelligence can actually improve operations while simultaneously reducing overhead, leading to meaningful ROI. It does this by working with existing technologies and technology infrastructures to automate administrative tasks and augment human intelligence. When you automate a task with AI, you can eliminate errors and increase speed of completion, while reducing cost to complete. 

There are countless opportunities within a practice to implement AI, from scheduling to clinical decision making. But where does it start for physician practices? It starts in the revenue cycle.  

Manual revenue cycle processes are hurting physician practices’ bottom line

Even as technology has improved, the healthcare revenue cycle processes for physician practices have not. In fact, many offices we encounter say that the technology has made the processes worse and more time-consuming. Each step from registration and insurance verification to submitting and following up on claims is an administrative task that takes time, costs money, and has the potential for errors. In 2009, it was estimated that for every 10 physicians providing care, almost seven additional people were engaged in billing-related activities.1  Surely the number has only gone up in the past decade, since reporting and insurance requirements have also increased since then.

The amount of digital paperwork and manual data entry related to the revenue cycle is not only increasing overhead costs, but also impacts a practice’s ability to get paid. One in seven insurance claims are rejected in the U.S.2 The more errors in the process and the longer the process takes, the less likely it is that a physician will ever see that money they are owed. Leaders of physician practices have traditionally faced two options: hire more office staff or leave money on the table in unpaid claims, but both “solutions” reduce profitability and don’t fix the underlying problem. Now, artificial intelligence has developed a third option.

Artificial intelligence can actually automate significant portions of the revenue cycle, unlike other solutions on the market today. Unlike simple robotic process automation (RPA), automation that incorporates artificial intelligence technologies like machine learning or computer vision can handle more complex tasks, making it perfectly suited for a routine, yet detailed process like the healthcare revenue cycle. It’s a more sophisticated technology, actually transforming the process for physician practices. 

Many hospitals have already implemented AI in their revenue cycles to great success, finding it an ideal starting point for artificial intelligence in their facilities. It is relatively quick and easy to implement and provides rapid results, both for the human workforce and the health system bottom line. Physician practices can also take advantage of these benefits by investing in an AI solution tailored toward their needs. 

What does AI in the physician practice revenue cycle look like?

Physician practices don’t have massive billing departments or IT departments. They need to be lean and efficient to make sure they are capturing all their revenue. Instead of worrying about getting paid, leaders should be thinking about their patients. 

At Olive, we’ve implemented AI solutions at over 900 hospitals, and that experience showed us the need that smaller healthcare organizations also have in the revenue cycle. We’re taking what we’ve learned and applying it to the physician practice revenue cycle, to lessen the RCM burden and continue to reduce costs for healthcare.

For example, we’ve developed an end-to-end prior authorization solution that actually connects provider and payer technologies. It automates much of the process on both sides, and even enables point-of-care prior authorizations when all medical necessity criteria have been met. 

For physician practices, we developed a unique solution that moves the revenue cycle burden from the practice to Olive. Olive Assures assumes the risk and responsibility of healthcare claims, making it possible to pay providers for care as soon as the service is delivered. Physician practices can reduce their overhead and increase their financial certainty. It works because we can use our advanced artificial intelligence capabilities to automate significant portions of the revenue cycle and appropriately calculate risk. 

For physician practices, it lets you take advantage of artificial intelligence’s benefits without having to manage a new technology. Olive Assures actually eliminates steps in the physician practice revenue cycle, making it a solution that will truly transform how claims are managed. As artificial intelligence increases its capabilities and becomes more ingrained in the future of healthcare, the revenue cycle is a tactical, focused area for physician practices to start their AI journey.

Is your physician practice ready to advance with AI?

Artificial intelligence capabilities have advanced rapidly, with meaningful solutions available today that help hospitals and physician practices alike reap the benefits of increased profitability and efficiency. But to ensure your AI actually achieves these promises, physician practices need the right technology partner.

You don’t have time to mess around with complicated implementations or ongoing IT maintenance. You just need a solution that does what it says it will, and performs day after day. With Olive Assures, you get a partner that takes on the revenue cycle for you, using AI to transform the processes on our end, and reducing cost and complexity on your end. Are you ready to learn more about how Olive Assures healthcare claims for physician practices? Schedule a call today.

Sources:

  1. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.28.4.w544
  2. https://link.springer.com/article/10.1007/s10796-021-10137-5


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