Using AI tools to reduce Revenue Leakage Presented by Mark Anderson
As presented at HBMA's 2023 Fall Conference September 26th-28th, 2023.
Using comprehensive and extensive new AI tools that pull data at the claim level, the RCM team was able to identify 10 areas of revenue leakage for a large hospital system with over 500 employee physicians in the Mid-West. By using the new AI tools, the team created an automated workflow and tasking process that identifies areas of improvement by claim level with actionable tasks. The results eliminated denials by 23%, improved the clean claim and first payment rates by 18%, reduced overall days in AR days by 22%, identify and reduced under payments by 18%, reduced bad debt by 37%, reduced open claims over 30 days by 32%, reduced liability claim (WC, Auto, and Personal Injury) AR over 90 by 32% and improved overall staff effectives and productivity by 17%.
Course participants will be able to:
- Learn how new AI tools can help your RCM team identify revenue leakage in a timely manner with measurable and attainable improvements that can help improve overall cash collections for your clients which leads to improve overall payments to the RCM company
- Learn how to quantify the improvements using base-line KPIs and through the use of the AI reporting tools, identify areas of improvement with actionable tools to improve effectiveness
- Learn how to communicate to your clients the overall effect of reducing revenue leakage and show how you can improve their bottom-line cash collections from 3 to 8%
- Quantify reductions in Days in AR by financial class comparing base-line KPIs to the results after using the AI tools and implementing new processes
Mark Anderson, CEO of AC Group, Inc. has been a healthcare executive for over 50 years. He has worked for and consulted in over 300 hospitals and with over 500 physician practices related to their daily operations, billing and RCM processes, technology decisions and procedures that are designed to increase cash flow and lower days in AR. – that is over 26,000 individual physicians.
He has been retained by over 300 practices to review their operations, finance, IT and RCM processes since the early 1970’s. Also, since early in the 1970’s, He has been actively involved in hospital and physician office administration, healthcare billing and finance, care team coordination, remote patient monitoring (“PRM”) and Healthcare Information Technology (including EHRs, Patient Portals, Health Information Exchanges (“HIE”), and advanced analytics).
He is a Life Fellow with HIMSS and a Certified Professional in Healthcare Information. He has been one of the national advisors to HBMA in the past working with Brad Lund. During his 50 years in Healthcare, he has been involved in financial and operational reviews and internal audits and has been responsible for evaluating numerous Key Performance Indicators and documenting changes in the KPIs over time.