Most revenue cycle strategies begin after the patient leaves the room. By then, documentation gaps, missed codes and underdocumented complexity have already made their way into the clinical note.
Becker’s Healthcare spoke with Kevin Wang, MD, Chief Medical Officer at Suki, about how connecting ambient AI, real-time coding and claims workflows at the point of care is reshaping revenue integrity — and how leaders can tell whether it’s working.
Editor’s note: Responses have been edited for length and clarity.
Question: Revenue cycle has traditionally been a downstream function. Why are more organizations shifting revenue integrity to the point of care and what does that require from clinical and revenue cycle teams?
Kevin Wang, MD: Revenue cycle has always had upstream and downstream pieces, but the middle of the encounter was often glossed over. That space is now expanding. With ambient AI, the point of care is not a single moment; it is a whole surface area where, with low latency, we can make improvements both before and after the encounter rather than only correcting the record afterward.
Q: Suki has reported an average increase of $2,600 per clinician per month along with a 48% reduction in amended encounters. What is driving those results, and how do you ensure better documentation improves coding accuracy without introducing compliance risk?
KW: It is less about recovery and more about accuracy of what historically has been forgotten, omitted or under-described. I call these the new watermelons, they are the lowest-hanging fruit. Think about a 45-minute visit where a pap smear was performed. In the old world, you had to document the visit after the fact, and details could easily be missed. In the ambient world, it is automatic. It also happens to be a code that reimburses more. Nothing is being added that did not happen in the room; the encounter is simply captured completely.
Q: Many health systems are trying to connect ambient AI, clinical documentation, coding and revenue cycle workflows. Where do the biggest integration challenges show up, and what should a successful implementation look like for health IT teams?
KW: Think of it as a combination of various strategies. Part of the strategy should be looking at what your EHR can do, part of it is looking at at third-party strategies, and a small part is what you build yourself. More and more, EHR strategy and ambient strategy are two different conversations, and teams that treat them as one tend to stall.
Q: Better documentation also changes what payers receive on the claim. How does more complete documentation at the point of care influence denials and appeals?
KW: It helps anywhere a deviation-from-rules rubric exists: utilization review, utilization management, ordering tests outside a typical age range, specialty medications, etc. All of those workflows benefit from documenting “the why”. That is what providers, payers and reviewers are looking for.
Q: For revenue cycle and health IT leaders evaluating this space over the next year, what are the first signs that point-of-care revenue integrity is working?
KW: In the coming months, organizations should see fewer queries back to providers, cleaner retrospective reviews and concurrent review KPIs with fewer blind spots. Those are the early signals that revenue integrity has genuinely moved into the encounter.
Hear more from Kevin Wang, MD, during Suki’s featured session at Becker’s Health IT + RCM. Learn more here.
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