There are a million ways patient billing can go wrong. Maybe a patient doesn’t understand their insurance coverage, or the demographic information that the provider has on file is incorrect. 73% of providers report that it takes one month or longer to obtain patient payments, and too often, those payments go to bad debt. What can providers do to combat payment challenges for better reimbursement? A unique and new approach in the healthcare industry is improving patient collections through artificial intelligence, or AI. Here are 3 ways artificial intelligence can improve the entire patient billing system and cut collection costs.
Reinventing the patient payment process with AI.
The first stage of a patient’s appointment begins before they see a physician or specialist. Each unique visit should be validated by staff under the patient billing system – the patient’s demographic information and insurance eligibility should be determined upfront. But what happens when that information is inaccurate? Poor management of claims can become detrimental to the health and sustainability of a practice. Artificial intelligence for medical billing, like ImagineAI™, can validate when a patient is eligible for primary insurance listed on the visit and/or your list of top payors before the claim is sent to insurance. Once you receive the positive eligibility response, the AI solution will add a note to the visit with the patient’s identified payment information. If the tool identifies that a patient is not eligible, it will run an identification verification check for the patient and will return the patient’s current demographic and/or insurance data.
Billing
How much money does your practice spend on patient statements? Consider the cost of paper, printing, postage and labor hours put into patient billing. Once the cost of sending out multiple statements to one patient is factored in, it’s possible that your practice is spending $5 to collect $15. There are more efficient and effective ways to cut collection costs and streamline statements. AI can calculate and assign patient grades based on a patient’s past and current financial status to prevent you from sending multiple statements to patients who are unable to pay their bills. The tool will perform a current and historical financial check for the patient, then return one of the four single letter grades that represents the patient’s likelihood to pay their bill: A, B, C, or D.
Follow-Up
If the tool returns a patient grade of D, it will run a Financial Aid check for the patient. This is useful in determining whether you should expend resources following up on patients with a low grade. If a patient with a grade of D doesn’t make a payment, the AI solution will update the patient's grade to E prior to the second statement being sent. This will prompt your patient billing system to stop sending any additional statements to the patient, will write off any existing charges for the patient, and will place any new charges that come into the system on hold. This means that you can re-target your resources towards patients who are proven to regularly pay for their medical bills.
Now that patient responsibility is at an all-time high, providers should look to solutions that will simplify the billing process in a way that saves staff time and cuts costs. Implementing AI into your daily workflow may sound intimidating, but it's something that is certainly attainable and a great way to increase revenue.