The healthcare sector faces ongoing challenges in maintaining an accurate and efficient flow of information and payments. With medical records and financial transactions consistently circulating among patients, providers, and payers, the demand for streamlined processes is paramount. The increasing complexities and pressures have imposed various hurdles on healthcare providers, necessitating innovative solutions. Addressing these issues, Fifth Third Bank and OrthoAlliance have undertaken initiatives to leverage data and technology to tackle the inefficiencies and hurdles within the industry’s financial operations.
Previously, Fifth Third Bank focused on aggregating data to create more efficient environments, key to enhancing cash-to-net-patient revenue collection. Concurrently, OrthoAlliance has been employing data-centric approaches, like using a simple SharePoint log, to ease payment tracking and reconciliation. Their current initiatives build on such groundwork, aiming for higher efficiency and automation in managing healthcare revenue cycles.
How are Mergers and Legacy Systems Adding to Complexity?
Mergers and acquisitions contribute substantially to the complexity of healthcare systems. As healthcare networks grow with integrated private practices and legacy systems, the challenge of integrating these disparate systems intensifies. Adam Keck of Fifth Third Bank underscores this, noting the industry’s continuous growth through mergers creates a challenging “legacy spider web.” Successful data integration is vital for reducing days in accounts receivable and improving revenue collection.
What Role is AI Playing in Resolving Revenue Cycle Issues?
Artificial intelligence is becoming increasingly relevant in revenue cycle management within healthcare. Traci Barney from OrthoAlliance highlights their exploration of AI for automating repetitive tasks like registration and payment posting. The goal is to streamline workflows, reduce manual processes, and free up staff for more complex duties. AI’s full potential will be realized when built on a strong data foundation, making strategic partnerships and acquisitions essential for its effective implementation.
Ensuring security and simplifying patient experiences are key focuses for both organizations. Keck details how robust data security measures stay essential against fraud threats. Meanwhile, improving patients’ comprehension of their financial responsibilities and offering clear payment options exemplify the efforts towards better service delivery.
“Our goal is to be straightforward and stress-free as possible for the patient,” Barney said.
AI and data initiatives also address rising payer scrutiny and denials. Barney mentions leveraging data to understand denial root causes, thus preventing recurrence. This proactive approach complements efforts to innovate revenue cycle management.
Bringing together vast amounts of data across merged entities and legacy systems with smart AI deployment offers critical insights. It reveals patterns that help prevent errors and streamline processes. These improvements not only reduce administrative costs but also alleviate patient billing confusion, promoting a smoother healthcare experience for all parties involved.
“The more that you can help the patient understand what they’re responsible for, give them the payment options and in a seamless environment … the more successful you’re going to be in collecting payments,” Keck noted.
The collaboration between Fifth Third Bank and OrthoAlliance showcases how strategic use of data, AI, and partnerships can transform handling healthcare revenue. As technology advances, institutions will need to remain adaptable and focused on integrating these elements to address growing industry pressures efficiently.
