Using Machine Learning in RCM to Overcome Staff Shortages

Accounts receivable revenue cycle management is an essential function of any healthcare provider, as it directly impacts the organization's cash flow. However, managing accounts receivable can be challenging, especially when there are staff shortages.

Fortunately, advances in technology have made it possible to use machine learning to overcome these staffing challenges and improve the revenue cycle management process.

Machine learning is a subset of artificial intelligence that involves training machines to learn from data and improve their performance over time without being explicitly programmed. In the context of accounts receivable revenue cycle management, machine learning algorithms can be used to automate tasks that were previously performed by human staff, thus freeing up valuable resources and improving efficiency.

One of the most significant benefits of using machine learning in accounts receivable revenue cycle management is that it can help to identify patterns and trends in insurance and patient payment behavior.

For example, machine learning algorithms can be trained to analyze insurance and patient payment histories, identifying those who are most likely to pay late, default on their payments or pay an amount that is different from what is owed.

This information can be used to prioritize collections efforts, ensuring that staff are focusing their efforts on the payers and patients who are most likely to have a positive impact on the company's cash flow and reduce staffing requirements.

Another benefit of using machine learning in accounts receivable revenue cycle management can also be used to improve the accuracy and usability of accounts receivable data.

For example, machine learning algorithms can be trained to identify recurring denial errors, ensuring that organizations can take a preventative approach to improvement and processes are up-to-date and accurate.

This can help to prevent payment delays or disputes, which can have a significant impact on cash flow.

To implement machine learning in accounts receivable revenue cycle management, there are several steps that healthcare providers can take. First, identify the tasks that can be automated using machine learning algorithms. This involves using machine learning to analyze current processes and identifying areas where staff are spending a significant amount of time on repetitive tasks.

Once these tasks have been identified, the next step is to gather and prepare charge, payment and transaction data needed to fine tune the machine learning algorithms. The data should be clean and free of errors to ensure that the algorithms can be trained effectively.

Once the data has been prepared, the next step is to select the appropriate machine learning algorithms and train them using the prepared data. This can be a complex process that requires expertise in machine learning and data science.

It may be necessary to hire outside partners like Etyon to ensure that the algorithms are properly pre-defined and pre-trained.

Finally, once the machine learning algorithms have been trained, they can be integrated into the existing accounts receivable revenue cycle management process flows. This might involve automating certain EMR work-queue tasks or providing staff with additional data and insights to help them prioritize collections efforts.

In conclusion, machine learning offers a powerful solution for overcoming staff shortages in accounts receivable revenue cycle management. By automating repetitive tasks, identifying patterns and trends in insurance and patient behavior, and improving the accuracy of accounts receivable data, machine learning can help businesses improve their cash flow and streamline their revenue cycle management processes. While implementing machine learning may require significant investment and expertise, the benefits are likely to outweigh the costs in the long run.

Learn more or read this article at https://www.etyon.com/thoughtleadership/using-machine-learning-in-rcm-to-overcome-staff-shortages