MGMA Webinar: Reinventing the Revenue Cycle with Ai, Analytics, & New Benchmarks
Healthcare revenue is bleeding margin. Learn how AI, analytics & ruthless performance benchmarks can stop the waste before system flatline.
The One Big Beautiful Bill Act isn’t just policy—it’s a seismic shift in how providers get paid. Shrinking coverage, rising administrative burden, and disappearing safety nets will punish revenue cycles still running on guesswork, lagging reports, or staff-heavy workflows.
The OBBBA imposes stricter Medicaid eligibility requirements, shorter retroactive coverage windows, and more frequent verification. This means more patients will arrive uninsured or will slip through the cracks—losing coverage between scheduling and service, submitting incomplete documentation, or failing new community engagement requirements. When teams miss these flags, claims get denied, and bad debt stacks up.
To stay ahead of the denials, you need Financial Clearance Automation, to ensure eligibility, benefits, demographic information and patient responsibility are all verified before the patient arrives. This reduces the chances of COB and eligibility denials and ensures a clean claim from the start.
Atlas Healthcare Partners increased their pre-service collections to 97.5%, zero touch rate by 124% and RCM labor capacity by 31% by leveraging Effective Intelligence® Financial Clearance Automation. With real-time visibility into staff performance, they eliminated rework, held teams accountable, and protected margins—even as coverage churn and payer demands escalated. When others were overwhelmed, Atlas was working smarter.
With less federal funding and more administrative burden, states are tightening how they reimburse providers. That trickles down fast—and suddenly, the same work yields less cash.
With the Effective Intelligence® suite of front and back office workflow automation and Intelligent Ai driven analytics– including a new set of Industry leading benchmarks–you get full visibility into where effort is spent and what gets paid. So when reimbursement gets squeezed, you can pivot instantly: reassign work, tighten front-end clearance, automate where possible, and hold teams accountable with real-time performance data.
Within the first year of implementation, our clients achieve our benchmarks with an average of:
Providers must now track, document, and prove more—just to get paid. That adds admin burden to already stretched teams and delays insight into what’s working.
With our real-time analytics with integrated conversational Ai, you don’t have to wait until the month is over to tell you what happened. You get instant visibility into performance and effectiveness of your RCM employees, problem payers, denials, provider performance and much more —so you can act fast. And you don’t need to be a data scientist to run reports. Simply ask the question and the answers are delivered to you in a clear, easy to understand format allowing you to make informed business decisions.
Our CA-based behavioral health client uses MedEvolve real-time analytics to identify stalled claims, reassign workloads, and prevent delays before they impacted cash flow. This resulted in a 5.2% increase in collections across the network.
Under OBBBA, you as a healthcare executive are being forced to change “the way we’ve always done it.” With more uninsured patients seeking medical help and fewer federal dollars to support care delivery, you can’t afford to be guessing at what’s getting paid and what’s being denied.
MedEvolve clients aren’t just surviving the shift—they’re thriving in it. With Effective Intelligence®, they’ve automated what doesn’t need human hands, cleared patients before the visit, and tied every staff action directly to a financial result.
If your current system can’t tell you how effective each team member is, what’s getting worked, what’s getting paid, where are your problems occurring in the revenue cycle and where money is leaking in real-time—it’s not enough anymore. Our clients are ready for what’s next. Are you?
View this session from the 2025 MGMA Summit and learn how Discovery Behavioral Health’s approach using Effective Intelligence® has realized a 5.2% improvement in cash flow, created 30% more capacity in its revenue cycle team and benefitted from a 13% improvement in zero-touch rates, a key performance indicator that illustrates the percentage of claims that get paid without any human intervention.
Don’t make high-stakes decisions for your healthcare organization with incomplete or misleading data. Traditional metrics barely scratch the surface. Using Effective Intelligence®, you can generate and track new revenue cycle benchmarks that focus on understanding where in the process avoidable touches are happening and effectiveness of staff. The ability to measure against these new benchmarks is key for a sustainable business today.
Effective Intelligence combines Patient Financial Clearance Automation, Medical Billing Workflow Automation, and Real-Time RCM Analytics in a cloud-based platform designed to integration with your current EMR/PM technology to measure the effectiveness of your RCM staff.
Review and assess your practice’s financial status in 5 min or less and know exact where you are losing money and why. Measure the work effort of every revenue cycle employee, incentivize and retain your top performers, and help employees that need improvement.
You can prevent most common denials, rejections and write-offs during the scheduling and pre-registration process in advance of the appointment. Configure checkpoints and use central task management to quickly clear patients and keep your front office staffing needs at a minimum.
As team members log in to the web-based application and record each “touch” of a claim, outcome, and next task, key data points are recorded like who completed the task and when, outcome, task notes, internal / external messages sent, collection success and other data points that feed into our real-time analytics.
Reduce RCM labor dependence with financial clearance, insurance A/R, & patient A/R automation modules with real-time analytics.
Increase productivity and simplify front & back office processes while keeping your staff focused with our flagship PM system.
Healthcare revenue is bleeding margin. Learn how AI, analytics & ruthless performance benchmarks can stop the waste before system flatline.
Under OBBBA, you as a healthcare executive are being forced to change “the way we’ve always done it.” With more uninsured patients seeking medical help and fewer federal dollars to
In this episode of Disruption/Interruption, Matt shares how generative AI and a focus on human accountability can help providers achieve “zero touch” claims, reduce waste, and improve access to care,
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