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Healthcare Payment Electronification

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The healthcare industry is beginning to realize the benefits of technology investments -- particularly in the areas of revenue cycle management, where costly and time-consuming manual, repetitive tasks lead to expensive administrative processes involving transaction processing. But there is more work to be done...

According the 2020 CAQH Index:

Of the $372 billion spent on administrative complexity in the United States healthcare system, $39 billion, or 10 percent, is spent conducting administrative transactions...

The industry can save $16.3 billion, or 42 percent of existing annual spend, by transitioning to fully electronic transactions...Meaningful opportunities for additional savings exist for both the medical and dental industries.

To achieve these potential savings, the healthcare industry is investing heavily in new technologies -- particularly Artificial Intelligence and Machine Learning -- to automate and streamline processes involving manual and time-consuming labor.

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OrboZone Healthcare Payment Electronification Experience

Experience a visual illustration of how healthcare is evolving in transaction processing. Each version of the Healthcare Payments Electronification includes a unique genre soundtrack. Do you agree that AI technology can help facilitate an electronic environment?

Healthcare Payment Electronification Experience - Version 1

Soundtrack Genre: Inspirational

Healthcare Payment Electronification Experience Experience - Version 2

Soundtrack Genre: Electronic

Healthcare Payment Electronification -- Powered by AI

Its hard to believe that 25% of healthcare payments are still fully manual, and 43% of remittance advices are either viewed through a web portal or fully manual! There is a huge opportunity to save the healthcare industry an estimated $2.5 billion.

Straight-through electronic processing is most likely not going to be achieved anytime soon. A hybrid environment is required to facilitate full automation. Electronification, using artificial intelligence (AI), converts PDF and paper-originated explanation of benefit (EOB) forms and correspondence letters into fully electronic data.

Electronification -- In Action

Here's how it works:

  • Paper-based remits of EOBs/EOPs are scanned, PDF documents are fed into the system
  • AI identifies field locations within the documents automatically
  • AI extracts the data from these fields
  • Sophisiticated quality control logic interprets the data and balances service-level transactions
  • An EDI 835 file is returned, ready for autoposting... Paper eliminated!
  • The result: Amazing accuracy resulting in less posting errors and reduced cost!
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The industry needs full adoption of this technology by RCM companies, clearinghouses, medical billers, and medical lockbox companies to eliminate the manual processing for healthcare providers. Learn more by checking out the links below to our RCM Electronification Case Studies and the Modernizing RCM with AI blog.

AI Revolutionizing the Healthcare Industry

AI is not just revolutionizing RCM in healthcare -- it is being utilized across the industry. Check out the fascinating ways AI is being leveraged for healthcare:

Cancer and Disease
Diagnosis

AI Helping in the
COVID-19 Fight

AI for Healthcare
Supply Chain Efficiency

According to cancer.gov: AI excels at recognizing patterns in large volumes of data, extracting relationships between complex features in the data, and identifying characteristics in data (including images) that cannot be perceived by the human brain. It has already produced results in radiology, where clinicians use systems to process images more rapidly. This also enhances the diagnosis process.

AI is a crucial tool in helping fight COVID-19. Here are a few examples:

The applications for AI in fighting future pandemics is limitless!

When healthcare facilities use AI and ML for enhanced supply chain management, they can cut waste and variations in supplies while boosting efficiencies.

The payoffs can be significant and encompass monetary savings, as well as more streamlined processes and less wasted time. Individual hospitals have opportunities to save an average of 17.7% in their total supply expenses.

 

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Photo Gallery: Healthcare Payment Electronification

Healthcare Payment Electronification and Revenue Cycle Management are represented graphically in many fascinating ways -- check some of them out in our visual gallery! (Hover over the image for description)

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