Intelligent RCM Engine

Overview

RCM services powered by intelligently automated workflows.

The AGS Health Intelligent RCM Engine is a proprietary suite of workflow orchestration tools that power our award-winning patient financial services. It seamlessly integrates artificial intelligence, machine learning, analytics, and digital workers to allocate work, automate tasks, and enhance decision-making. With the Intelligent RCM Engine, our staff can achieve peak productivity, efficiency, and accuracy—the net result is higher quality and greater cost-efficiency for our valued customers.

Intelligent RCM Engine Overview

Data-Driven Workflow Logic

Our advanced logic system leverages claims data and custom rule sets for each customer to ensure that tasks are distributed to the right resources at the right time for optimal performance and financial outcomes.

Enhanced Productivity and Collaboration

AGS Health’s smart workflows connect disparate systems and streamline processes through intelligent automation to boost productivity, encourage collaboration, and support faster claim processing times.

Faster Returns, Lower Costs

By automating mundane tasks and offering suggestions for the next best actions, AGS Health can dramatically reduce the time and cost of collecting revenue for our valued customers.

Features

Intelligent RCM Engine Features and Capabilities

Dynamic Centralized Workflows

Rapid ingestion of claims data

Whether through integration or upload, our system tracks the inflow of claims for immediate allocation and processing.

Centralized allocation of workloads

Our proprietary central allocation technology automatically separates, prioritizes, and assigns claims to our service teams and/or digital workers based on a set of custom rules to support each customer’s unique requirements. This ensures the correct claims are delivered to the most appropriate resource at the right time for optimal throughput and cash flow.

Tech-Enabled Work Processing

Automated web transactions

For claims that require additional patient data or other information, Intelligent RCM Engine leverages pre-built Robotic Process Automation (RPA) and more than 240 pre-built Application Programming Interfaces (APIs) to pull information from payers’ Electronic Data Interchange (EDI) transactions whenever possible.

Voice-based digital workers

Voice-based technologies like Interactive Voice Response (IVR) automation and Speech Text (STT) transcriptions help eliminate lost productivity caused by extended hold times and empower our proficient staff to focus their attention on more valuable and complex tasks.

Technology augmented appeals

After obtaining and confirming all essential claim data, we utilize intelligent automation to enhance the denial reconciliation process. This assists in creating and submitting appeals packets, reducing the time to revenue for our clients.

Digital RCM consultant

An AI-powered conversational interface equipped with over 400 custom workflow scenarios provides our staff with step-by-step guidance and recommended actions tailored to each customer’s specific workflow requirements, enhancing efficiency and cost savings for our customers.

Enhanced Audits and Business Intelligence

Streamlined audit insights

An embedded auditing system featuring advanced analytics and AI oversight upholds strict regulatory standards while providing critical insights for strategic decision-making. Integrated with our centralized workflows and tech-enabled processing, it efficiently highlights discrepancies and opportunities for improvement, enhancing operational efficiency and driving continuous improvement.

Data-driven process improvements

Comprehensive business intelligence analytics and reports allow customers to monitor key performance indicators to assess progress and identify opportunities for process improvement.

BENEFITS

Experience the impact of the Intelligent RCM Engine.

With the Intelligent RCM Engine, our customers can expect industry-leading claims processing performance at a highly competitive value.

95%
Resolution for Addressed A/R
95%
Cash Collection as a Percent of Net Revenue
<15%
A/R Older than 90 Days

Integrations

Connects with any system