Game-Changing AI Innovations: How eClinicalWorks is Redefining Revenue Cycle Management with AI

Interweaving cutting-edge and affordable artificial intelligence (AI) across all aspects of medical practice is helping to reshape the healthcare industry and how practices deliver care. eClinicalWorks is at the forefront of this new AI age of intelligence.

Revenue Cycle Management (RCM) remains critical to sustaining healthcare practices, and eClinicalWorks AI-powered RCM solutions are changing the status quo and redefining the end-to-end billing process. Due to ongoing staffing challenges, complex rules, and policies, practices would often need to outsource RCM management to third parties. eClinicalWorks is one of the few vendors in the healthcare IT industry that offers clients a choice of a self-service Practice Management model or a complete end-to-end billing solution with an RCM Service model, with a 98% or higher first-pass acceptance rate. With new innovative AI solutions, eClinicalWorks is reshaping the entire RCM process, helping to reduce administrative burdens and associated costs and ultimately freeing up providers’ time and energy to focus more closely on patient care.

These transformative AI technologies streamline billing, coding, insurance eligibility, and appeals management processes, reducing the time and effort required of the billing staff. This integration helps minimize errors and accelerates the billing cycle, ensuring that healthcare providers are reimbursed faster and more accurately. At the 2024 eClinicalWorks and healow National Conference, eClinicalWorks introduced AI-driven RCM solutions to streamline the end-to-end billing process for healthcare practices and replace RCM as a service.

Alleviating Staffing Shortage Gaps with eClinicalWorks Autonomous AI Tools

Staffing shortages significantly affect RCM efforts. In a recent Experian survey of healthcare workers responsible for staffing the revenue cycle function, 100% of respondents reported that staffing shortages have negatively impacted RCM and/or patient engagement. Additionally, the survey found that 53% of respondents reported that staff burnout due to RCM is a major cause of employees leaving their roles. eClinicalWorks AI technologies stand to be an impactful solution that alleviates provider and patient challenges.

Assisted by eClinicalWorks AI copilots, staff will now have the bandwidth to focus on patient engagement, claim exception management, and complex RCM scenarios that require their specialized skill set, preventing AR backlogs due to a lack of time and attention from the staff. eClinicalWorks AI-powered RCM streamlines the check-in process – recognizing insurance card details, customizable payment plan options, and notifications if a card on file is set to expire.

Automating Eligibility with eClinicalWorks AI-Powered RCM

AI can alleviate administrative burdens and speed up billing operations by automating interactions between healthcare practices, insurance companies, and patients. eClinicalWorks AI-powered eligibility insights curate pertinent coverage information for the specific patient visit, helping to identify potential eligibility issues and deductible information, and allowing staff to spend less time reviewing and discovering patient responsibility.

Ensuring Back Office Accuracy and Efficiency

eClinicalWorks AI RCM converts explanation of benefits (EOBs) to electronic remittance advice (ERAs) within minutes, bringing significant time savings to practices. Converted ERAs are queued for posting once payment is received, helping automate the entire payment posting process.

Appeals are a common part of RCM, and while they are unavoidable, eClinicalWorks AI enhancements are reducing administrative burdens by assisting in generating appeal letters and suggesting additional documentation needed. The eClinicalWorks AI assistant also helps prevent errors before claims are sent out by building and recommending rules from analyzing claim denials. This will save time and improve accuracy, helping practices handle denials more efficiently.

Leveraging AI Solutions to Identify Coding Gaps

Documentation of progress notes differs based on each physician’s style. The eClinicalWorks AI assistant scans documentation and identifies any gaps in coding. Additionally, the AI assistant recognizes and suggests any missing required supporting documentation.

eClinicalWorks AI Analytics and Interactive Dashboards

Practices can further personalize and optimize their RCM solutions with eClinicalWorks AI analytics, where users can generate interactive dashboards with natural language conversations and AI-powered deep search functions that enable practices to quickly find the information they need in claims, accounts collections, and payments. These options give providers the flexibility to choose which solutions best fit their needs while also enabling them to seamlessly monitor KPIs, receive real-time updates, and reap the benefits of highly comprehensive tools for reporting and analytics.

Redefining Revenue Cycle Management

eClinicalWorks is leveraging AI to make outpatient management seamless for providers, and RCM stands to be one of the key day-to-day tasks that can be reshaped by these technological innovations. eClinicalWorks AI solutions drastically enhance efficiency and productivity, freeing billing staff from time-consuming and mundane administrative tasks while eliminating the need for third-party involvement. At the same time, patients can benefit from a better understanding of their billing process. Through the adoption of eClinicalWorks AI products, healthcare practices can strengthen their RCM processes and streamline this crucial information for patients.

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