(2 min read) Data science made advances toward artificial intelligence (AI) for years, which encouraged scientists to believe the dream of a machine “thinking” could be a reality. Yet, the advancement of AI was slow and ultimately, held back by the limits of data processing.
Interestingly, the same developments in data science which underpin AI are likely to have the greatest impact on your revenue cycle. Today, the ability to source, harness, and leverage data — rather than artificial intelligence — is leading the way in increasing dollars collected by providers and health systems.
Big Data and Revenue Cycle Management
The best claims — those most likely to be paid quickly — include the most accurate data available before a patient is ever billed for their portion. Big data now enables surgery centers and hospitals to provide the most up-to-date billing information, which helps with patient-hospital relationships (no more erroneous bills sent to patients), as well as increased reimbursement rates. There are technology tools readily available to surgery centers and hospitals that can provide this type of in-demand data.
Dynamic AR Optimization Technology
Nationally, 60% of claims submitted on average contain incorrect patient information. By using insurance discovery and demographic verification technology, patient profile errors and missing information are eliminated. This technology verifies patient insurance and seeks out any hidden or unknown billable coverage during services rendered. Obtaining this information at the pre-billing stage can have incredible benefits to ambulatory surgery centers and hospitals.
Patient Financial Characteristics, Reimbursement, and
Big data is also creating significant gains as the patients out of pocket responsibility continues to rise. As a revenue cycle professional, you are faced with the difficult task of not only delivering bad news to the patient about what his policy does not cover, but also having to ask for payment. All too often this results in the erosion of both the patient relationship and the provider’s profitability. The good news is that self-pay analyzer tools have an 83% increase in collections from uninsured patients and a 22% increase in collections from insured patients.