Shulou(Shulou.com)05/31 Report--

Bian Shaw found that many friends were interested in the information that AI would be able to check the status of outstanding claims and notify the payer of the acceptance notice. Bian Xiao collated some relevant information for AI to check the status of pending claims and notify the payer of the admission notice to share here.

MBA Anthony Cunningham, vice president of financial services for patients at the Wake Forest Baptist Health Center, said that as costs continue to rise, medical institutions must improve collection efficiency. One way, he explains, is to move employees away from repetitive tasks and "to high value-added work".

This is the source of artificial intelligence. Cunningham introduced an artificial intelligence strategy in Wake Forest, which uses robots to check the status of outstanding claims and notify the payer of admission. The robots will release people to handle complex cases while performing these tasks, which may "bring more money to the organization," he said. "in the past, we asked staff to log on to the payer's website, first check the A to D fields, and then return a value in the E field, and then we built a robot to perform exactly the same operation as the staff," he explained. " These are simple tasks that artificial intelligence is good at, he added.

He stressed that AI should not be confused with machine learning, noting that Wake Forest executives would soon approve the use of AI for such "transactional" tasks, in part because it was a low-risk job. Machine learning to analyze data and use algorithms is a greater challenge, and errors are more meaningful.

Another reason the robot strategy is easily accepted, he says, is that it can build production capacity without hiring more people. First, it frees up time for the revenue cycle team to focus on complex accounts receivable tasks. Secondly, robots can work around the clock. According to Cunningham, the result is an opportunity to greatly increase productivity. "it is possible to replicate the productivity of up to 13 full-time equivalent employees without hiring others," he said.

Moreover, his employees will do more interesting work and reduce the risk of burnout. "We hope to improve the experience of our employees by giving them more thinking tasks than redundant work," he said. "

Synchronize with other policies.

After Wake Forest perfects the use of AI in claims inspection and admission letters, they will turn to simple authorization, which is to go back and forth with the payer on clinical issues without much cost. Next, we will discuss the feasibility of using machine learning to capture the efficiency of clinical documents. This is a bigger step forward because you start to get into clinical outcomes, which brings more risks. You must be very strategic.'

While Wake Forest is not the first company to enter these areas, Cunningham's overall goal is to be one step ahead, "mature in the market and ready to use it when developing new options."

For business leaders who want to get involved in these areas, he suggests considering their culture. Are you willing to accept change and try innovative ways to reduce costs? Does your management team have the technical ability and confidence to try new technologies without "being too aggressive and introducing unnecessary risks"?

Cunningham insists that artificial intelligence will not disappear. "in order to meet the need to improve collection, you have to consider innovative ways to interact with the payer," he said. "if used properly, artificial intelligence can help you achieve your goals."

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