Ask a Revenue Cycle Leader is a new series featuring insights from health system and hospital revenue cycle executives nationwide. Becker’s poses questions on the most pressing issues in healthcare finance — from payer relations and automation to workforce and patient experience. We welcome responses from all revenue cycle, finance and reimbursement leaders.
Question: What’s been your biggest AI win in the revenue cycle — and what difference has it made for your team or your bottom line?
Editor’s note: Responses were lightly edited for clarity and length.
Tony Morrison. Vice President and Chief Revenue Officer at Sanford Health (Sioux Falls, S.D.): Autonomous coding has been a huge success at Sanford. Finding experienced coders is difficult and retaining them is also a challenge. By implementing autonomous coding — with just one specialty (radiology) — we were able to reduce over 20 FTEs. We will be expanding into other areas based on these results with even more opportunities for reductions and efficiency. Note: We planned in our pro forma to reduce 20 FTEs over three years. We were able to take them out in the first six months.
Marji Karlin. Chief Revenue Officer at NYC Health + Hospitals (New York City): I’ll highlight two of several revenue cycle wins in the AI space, each helping streamline workflow and enhance our ability to collect insurance payments for the services we render. We developed a charge capture module which compares charges billed to the services performed and highlights potentially missed charges. We have also developed and implemented a tool used by care managers, which summarizes the chart and helps them help doctors select the correct diagnosis for admissions. Another version of that platform is using AI to draft appeal letters for when claims are denied for medical necessity.
Next question: How are you working to develop the next generation of revenue cycle leaders? If you are interested in responding please send responses to Andrew Cass at acass@beckershealthcare.com.
