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Revenue Cycle Automation

Overview

Automate, Optimize, and Forecast Revenue Cycle Workflows for Peak Performance.

With the Revenue Cycle Automation module, tedious and repetitive tasks can be managed autonomously, enabling your staff to focus on more meaningful, value-added activities. Our cognitive digital workers can perform tasks and operationalize the next best actions based on data, heuristics, and machine learning. Its built-in data fabric, intelligence engine, and actionable worklists allow this module to learn and adapt to your environment. ​

A/R Insights

Preview outcomes of your facilities’ current accounts receivables and cash flow based on predicted payments and denials.

Collection Optimization

Optimize your organization’s internal collections department and staff with algorithmic work queuing and NLP-based worklist prioritization.

Billing Optimization

Avoid preventable denials with verified demographics, eligibility, authorization, and billing guidelines.

Process Automation

Complete automation of labor-intensive insurance authorization, medical billing, claim denials, and payment posting functions.

FEATURES AND CAPABILITIES

Computer-Assisted CDI Features and Capabilities

Avoid Errors and Prevent Denials
Reduce downstream denials during admissions
Protect your revenue from the point of patient admission by leveraging accurate and repeatable automation for demographic verification, insurance verification, and prior authorization.
Scan and correct claims prior to submission
Our intelligent AI integrates with claim scrubbing solutions to determine code combination, medical necessity, or identify required modifiers before submitting the claim.
Resolve and analyze denial trends
Natural Language Understanding (NLU) and Machine Learning (ML) powered workflows identify denial codes to automate denial resolution with minimal coder and auditor involvement.
Increased Collection Rates
Submit claims with confidence
Automate charge entry to create efficiencies for coders and billers, resulting in improved efficiencies and reduced errors.
Focus on the claims that need attention
Pre-configured AI posts Electronic Remittance Advice (ERA) into the respective patient accounts, allowing your payment poster to focus on complex claims.
Identify payment gaps automatically
Our platform mimics your finance analyst and identifies payment variance and outliers so that your analyst can work on remediation for complex payment methodologies.
Improved Operations and Reporting
Measure performance in real-time
Gain an at-a-glance view of relevant information for each user with customizable dashboards. Build executive reports and review the status of your revenue, RPA solutions, and global staffing instantaneously. 
Oversee operations and workflows
Manage your global operations in one centralized location, while eliminating excess emails and other tedious tools. Monitor team performance to assess productivity, identify bottlenecks, and more. 
Stay on top of tasks
Task management features help avoid missed deadlines and prioritize your team’s work queues for improved efficiency with intelligent worklists. 
Case studies
Case Study
El Paso Children’s Hospital Improves CDI Productivity by 50% with AGS Health
Case Study
Computer-Assisted Coding Decreases Claim Denials by 30 Percent

Resources

Dig deeper into Revenue Cycle Automation

El Paso Children’s Hospital Improves CDI Productivity by 50% with AGS Health