BY Jasmyne Ray for Health Leaders
Artificial intelligence has moved from a buzzword to an established presence in revenue cycle technology. Revenue cycle and finance leaders alike are looking to AI to streamline processes and automate tasks, which will allow them to use staff more efficiently as the sector-wide staffing shortage persists.
HealthLeaders previously spoke to Joann Ferguson, vice president of revenue cycle for Detroit-based Henry Ford Health on how they’re using AI to help with coding.
“First, it automatically codes the simplest procedures, taking that work off our coders’ plates,” she explained. “By ‘simplest,’ we mean the procedure notes that match closely or exactly with how the ICD codes themselves are written.”
Denials management is an area revenue cycle leaders continuously struggle with. Going into 2024, Sierra View Medical Center in California have begun working with a vendor that uses AI to help with the appeals process.
“On the inpatient side of business, we have seen a large increase in denials for lack of medical necessity,” Julie Franer, administrative director for revenue cycle, told HealthLeaders. “Our [utilization review] department now reports to finance and will be focusing on education related to documentation to avoid medical necessity denials.”
An organization’s adoption of AI or any technological solution is dependent on a few different factors. Where are they currently with technology, and how much should they expand? Will C-suite executives be onboard? Can they afford the investment?
“Many organizations have already begun to optimize processes utilizing technology while others are still in the infancy stages,” Shawishi Haynes, director of revenue cycle operations at Valley Presbyterian Hospital in California told HealthLeaders.
“It will take time to see every organization using technology in the same way due to the differences in organizational philosophy, financial position and technological growth.”
