5 considerations for automation and machine learning in revenue cycle operations

Automation is quickly becoming one of the most popular topics among healthcare financial executives as they explore new ways to reduce expenses and improve operational performance, according to Grant Messick, managing director of customer success at Alpha Health.

During Becker's Health IT + Revenue Cycle Management Virtual Forum Feb. 10, Mr. Messick discussed key considerations for automation and machine learning in revenue cycle operations and the factors healthcare organizations should look for when selecting a vendor partner.

Five insights and considerations for choosing an automation and ML partner for revenue cycle operations:

1. Ask questions and evaluate the vendor to ensure they will deliver on your organization's needs. Some questions to consider: "Are these people revenue cycle experts or just tech professionals who don't understand the operational effects of revenue cycle?" and "Does their team have machine learning engineers who actually built the RCM product or is it more of a robotic process automation product they're calling AI?"

2. Understand the multiple components of their performance standards, including cost and quality of their product. Use actual data points in case studies from the vendor's work to determine if their solutions affect revenue or reduce denials.

3. Consider how the automation RCM partner will work with your organization from a project management perspective.

"Start small – pick one workflow and automate it and do it well," Mr. Messick said. "Knock it out of the park, get one thing going, and then start to build upon that partnership… You start with something that's going to deliver some value, but also help show whether that vendor is up to snuff. From there you can start to grow and build additional workflows, additional tasks and grow your initiatives together."

4. Ensure the vendor's pricing calculation model aligns with your organization's method. These different models include basing the process on cost savings, return on investment promise, subscriptions and tasks.

5. Verify that your vendor of choice is fully certified across all the various security and compliance areas your health system requires.

"If you are going to be granting access into your billing system, you want to make very sure that your vendor has gone through all of the rigor to achieve all of the necessary certifications, has the appropriate documentation with you and your health system, and has that risk management process in place in order to protect you from additional risks," Mr. Messick said.


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