MedEvolve Is Fixing Healthcare’s Revenue Leak | Matt Seefeld | Business Ninjas Podcast
MedEvolve CEO Matt Seefeld breaks down where these leaks happen and how providers can seal them off.
The revenue cycle, a cornerstone of healthcare operations, is poised for transformative advancements through generative AI. While traditional AI applications in revenue cycle management (RCM) have leveraged common, system-generated data, the real breakthrough lies in integrating this with human-generated data to unlock unparalleled potential. How does MedEvolve bridge the gap? Explore infographic below.
System-generated data—drawn from practice management (PM) systems, clearinghouses, scheduling platforms, and claims—forms the backbone of many AI-driven RCM solutions today. This data provides insights into operational trends and supports foundational tasks such as claims processing and scheduling optimization. However, it often lacks the nuance necessary to understand where the breakdown occurred in the revenue cycle that required human intervention for claims adjudication.
Human-generated data bridges this gap. The data reflects real-world actions, decisions, and outcomes that are undocumented in traditional systems. Human-generated data allows revenue cycle leaders to understand why medical claims are not paid on the first pass, all the activity involved in getting a claim paid, as well as measure the productivity and effectiveness of staff. Workflow automation solutions that measure every touch in the revenue cycle process create this superior data set.
By combining system-generated and human-generated data, generative AI models can better understand and predict workflow dynamics that can help organizations quickly diagnose and fix problems. This dual-input approach lays the groundwork for smarter, more adaptive solutions in machine learning, robotic process automation (RPA), and prescriptive analytics.
The true power of generative AI in the revenue cycle lies in its ability to refine processes and build smarter work drivers. By analyzing combined datasets, these models can uncover patterns that drive efficiency:
Generative AI and human-generated data significantly improve labor costs and performance in the revenue cycle by reducing wasted touches. Here’s how they contribute:
As the revenue cycle evolves, generative AI offers a promising avenue for enhancing efficiency and outcomes. However, its success hinges on bridging the divide between system and human-generated data. By investing in technologies and strategies that capture and integrate these data streams, healthcare organizations can unlock the full potential of AI-driven RCM solutions.
This transformation is not just about automating existing processes but reimagining them. With smarter work queues, improved task assignment, and a data-rich foundation for decision-making, generative AI can redefine success in revenue cycle management.
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.
MedEvolve CEO Matt Seefeld breaks down where these leaks happen and how providers can seal them off.
Discovery Behavioral Health improved revenue cycle efficiency and margins by partnering with MedEvolve to implement AI-powered automation and analytics. This reduced administrative waste, decreased avoidable touches by over 60%, increased
Discover how reducing avoidable touches in insurance claim processing can cut costs, free up labor capacity, and boost revenue cycle efficiency—saving organizations hundreds of thousands annually.
Discover how MedEvolve’s revenue cycle benchmarks come to life through Effective Intelligence® real-time analytics dashboards.
