EFFECTIVE INTELLIGENCE®

Medical Billing Workflow Automation

Workforce automation to track every claim touch and and manage staff performance

Add Insurance & Patient AR Automation to your current PM/EMR systems

Wasted human touches on insurance claims are eroding margin for healthcare organizations, yet most have no insight into how many touches it takes to get a claim paid and how many of those touches are not generating revenue. MedEvolve’s AI-driven medical billing automation, part of the award-winning Effective Intelligence (Ei) suite, is designed to reduce administrative waste and manual work effort to ensure maximum efficiency with complete oversight and reporting on every step.

How we track human touches

As medical billing team members log in to the workflow automation web-based application each touch of the claim is recorded as structured data, including the activity, status, action, tasks and notes and who was responsible. This data feeds into our Advanced Real-Time Analytics so leaders have complete transparency into the quality of the work being done. Managers can view staff members’ progress, make suggestions for improvement, provide additional training if needed and ultimately reward individual team members that generate the best results with the least amount of work.

Eliminate the noise & optimize labor capacity in the revenue cycle

Administrative waste drives 26% of all wasted healthcare spending according to a JAMA study — billions lost to inefficiency. Every unnecessary claim touch costs time without moving a claim closer to resolution. Effective Intelligence® workflow automation changes that. By generating dynamic worklists and prioritizing claims, it keeps your RCM team focused only on what matters. Before implementing Ei Suite, clients typically see about a 40% zero-touch rate and 60% avoidable touches. Afterward, those numbers flip — 80% zero-touch and only 20% avoidable.

Increase Zero Touch Rate

The ultimate goal is for claims to be processed and paid without anyone in billing touching them. Our clients typically start around 40% and increase to 80% or more within the first year of implementing Effective Intelligence® reducing labor costs in the back office using our Financial Clearance Automation module.

Current State

Reduce Avoidable Touches

Once the claim gets to the AR team, most of the work is wasted on activities that will not produce a payment such as checking on a claim before it’s processed. With organized worklists and a clear workflow, most of our clients are able to resolve most claims within the first interaction from the RCM representative.

Attainable Goal

With Effective Intelligence®,
Compass Healthcare achieved

0 %

decrease in labor dependence

0 %

decrease in denials

0 %

decrease in AR over 60 days

0 %

increase in net collection rate

“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

Effective Intelligence Technology

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.