2025 MGMA Summit Session: Revving up RCM with AI and Automation for a Lean Workforce
Discovery Behavioral Health increased cash flow by 5.2%, team capacity by 30% & zero-touch insurance payment rates by 13%. How did they do it?
MedEvolve empowers healthcare organizations with award-winning Effective Intelligence (Ei) solutions. MedEvolve’s Ei solutions include workforce automation and intelligent analytics designed to optimize the entire revenue cycle process from financial clearance to medical billing. With our generative AI engine, these solutions can pin-point exactly where changes are happening in the revenue cycle, good or bad, and tell you why. We do this by tracking and measuring the human generated data – every touch your staff is making in the revenue cycle in the attempt to adjudicate claims.
A clean claim is one that leaves the office “clean” (without errors) and is paid timely. But how much work did the claim require before it left the office? When coordination of benefits and coding are done right the first time, back-office work effort is “zero”. Front office patient financial clearance is responsible for over 50% of denials. Zero Touch Resolution Rate indicates that the back office medical billing department spent no time processing the claim.
of touches are wasted in the revenue cycle
of open claims do not need to be touched today
Administrative waste accounts for 26% of wasted healthcare spend! Billions of dollars are at stake. You cannot afford wasted touches in the revenue cycle – non-actionable activities that your team performs that do not resolve a claim. Effective Intelligence workflow automation generates worklists and prioritizes claims to keep your RCM team on track. Calculate what your potential labor cost savings could be if you reduce your claim touches.
zero touch rate
decrease in labor dependence
Increase in Labor Capacity
Reduction in Denials
We are thrilled with the outcomes achieved with MedEvolve. Our leaders have tremendous confidence in the partnership. We look forward to expanding our work with the MedEvolve team to derive even greater value from data insights, which is key to our success as a growing business.
Heather Richards, Chief Financial Officer, Atlas Healthcare Partners
Reduction in Labor Dependence
Reduction in Denials
“MedEvolve solutions have transformed our revenue cycle team’s operations significantly. My team is able to organize their days more easily through the tasking functions than when we were relying on emailing different locations back and forth.”
Sandra Holdorf, Revenue Cycle Manager, Compass Healthcare Central Billing
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.
Discovery Behavioral Health increased cash flow by 5.2%, team capacity by 30% & zero-touch insurance payment rates by 13%. How did they do it?
Matt Seefeld, President of MedEvolve, exposes the hidden inefficiencies and financial chaos plaguing the U.S. healthcare system. From denied claims to overwhelmed billing departments, he explains how outdated processes are
Reimbursements are shrinking, labor costs are rising, and consumers are paying more. The pressure is on, but most revenue cycle teams still can’t answer a critical question: What’s really driving
Before investing in the latest AI-powered platform, ask yourself: Do I know what’s really broken in my revenue cycle? The bottom line is you can’t fight bots with more bots.
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