<img alt="" src="https://secure.dawn3host.com/210977.png" style="display:none;">
Modernizing Revenue Recovery Through the Power of AI
Blog Feature
Brian Kenyon

By: Brian Kenyon on February 20th, 2023

Print/Save as PDF

Modernizing Revenue Recovery Through the Power of AI

revenue cycle contract management  |  Reimbursements & Recovery

A revolutionary new AI tool is poised to change how healthcare organizations manage revenue recovery and protect cash flow.

To say that the revenue cycle management technology market has exploded would be an understatement. Since 2020, the revenue cycle management market has grown by tens of billions of dollars and shows no signs of slowing down.  

Even though healthcare organizations are investing billions in revenue cycle management, revenue recovery has remained a pain point for many healthcare entities. However, the emergence of a dynamic, AI-powered recovery tool has the potential to forever change the way that healthcare organizations recover revenue from payers.  

Join us as we examine modern healthcare organizations' greatest revenue recovery challenges and demonstrate how this powerful new tool can streamline this historically tedious process.  

What Is Revenue Recovery? 

Revenue recovery is the process of identifying and collecting on denied or underpaid accounts. Revenue recovery aims to increase the collection rate and improve an organization’s bottom line. 

The most important and typically most labor-intensive component of revenue recovery is account identification. Identifying denied or underpaid inpatient and outpatient accounts can be incredibly difficult due to the number of accounts that come in daily.  

Oftentimes, accounting personnel will waste hours or even days pursuing a handful of accounts, only to find that their collection efforts yield no additional revenue for the organization.  

What Are the Biggest Challenges Associated with Managing Healthcare Revenue?  

Every healthcare organization faces challenges when it attempts to recover revenue on delinquent or underpaid accounts. However, most of these challenges stem from one of three major underlying issues, which are as follows: 

Inadequate Staffing 

It’s no secret that a talent shortage has ravaged the healthcare industry. Deloitte has infamously categorized the shortage as a full-fledged “talent emergency.”  

While many discussions about the healthcare talent shortage are centered around clinicians and front-line workers, a lack of back-office personnel has also negatively impacted hospitals. 

Accounting department teams frequently become overwhelmed by the extreme volume of accounts receivable they must process. Many teams do not have enough time, resources, or personnel to process standard accounts promptly, much less double back to address delinquent ones.  

Tight Submission Deadlines 

Payers are notorious for their tight submission deadlines and zero tolerance for coding discrepancies. However, coding errors and missed deadlines have become the norm in many hospital accounting departments. Coding errors result in an unsustainably high number of claims denials, and missed deadlines can lead to disrupted cash flow. 

Manual processes are not nearly efficient or cost-effective enough to meet the stringent submission deadlines of payers. Organizations that continue to lean into these practices will face mounting claims denials and fall prey to a never-ending cycle of missed deadlines.  

A Lack of Sufficient Tools 

Many healthcare accounting teams simply do not have access to the tools or analytics solutions necessary to engage in effective revenue recovery. While there are many reasons organizations have failed to invest in such tools, a major concern is how much adopting a new system will cost.  

According to a Deloitte survey, 36% of healthcare leaders were concerned about the costs associated with implementing AI. 

However, it appears many of these concerns are misplaced, as artificial intelligence solutions have the potential to produce a strong ROI and make a positive impact on organizations in general. For instance, 69% of healthcare analytics decision-makers state that implementing AI technologies benefited their organization. 

How Can Healthcare Entities Streamline Revenue Recovery? 

One can boil down most of the challenges associated with revenue recovery to a few key issues, including the following: 

  • Ineffective tools 
  • A lack of clear direction 
  • An insurmountable volume of work 

Fortunately, artificial intelligence has the potential to expedite revenue recovery processes and address all three of these collection hurdles. By implementing modern AI-based recovery solutions, your business can: 

Give Your AR Team Clear Direction 

Far too many analysts waste precious hours exploring the wrong accounts. Most analysts lack clear direction or a good starting point when initiating the revenue recovery process. At first glance, it is nearly impossible to differentiate potentially valuable accounts from those that cannot be recovered. 

AI technology eliminates this challenge by providing your AR team with clear guidance on what accounts to pursue. A solution like PMMC’s system takes this a step further with automated views that show the assigned accounts to the assigned users, further expediting revenue recovery. 

Automate Redundant Processes 

In addition to including AI technology, solutions like RecoveryAITM also use machine learning and automation tools. Cumulatively, these tools reduce a recovery team’s reliance on manual processes and maximize productivity. 

The automation capabilities of RecoveryAITM can create trickle-down benefits as well. For instance, it can reduce the workload on team members, thereby boosting morale and efficiency.  

Stop Wasting Time on the Wrong Accounts 

As a recovery specialist, few things are more frustrating than spending hours on an account only to discover that it is a fruitless endeavor. But this very scenario plays out time and again in just about every revenue recovery department in the nation. 

RecoveryAITM can make this problem a distant memory by prioritizing the most recoverable claims. 

Unlock Your Revenue Potential with PMMC’s RecoveryAI 

PMMC’s RecoveryAI solution was designed to systematically alleviate the pain points associated with today's revenue recovery. PMMC's artificial intelligence-powered recovery platform includes powerful automation tools and workflows that expedite the accounts receivable management process in the healthcare setting.  

Specifically, PMMC's platform prioritizes and through scoring and automates the work views of accounts to your AR staff. It reduces the level of priority on low-value or dead-end accounts so that your team stops wasting time on uncollectable variances. Instead, they can focus their energy on pursuing valuable accounts and collecting revenue for your organization.  

The analytics capabilities of Recovery AI provide your management team with actionable insights that they can use to guide decision-making and further refine collection practices. 

"The capabilities of RecoveryAITM are not just conjecture. PMMC has already achieved profound results by utilizing our RecoveryAITM platform. Since launching RecoveryAITM, our PMMC Recovery Specialists have helped clients increase collection rate by 2.2 times and payer submissions by 2.4 times", stated Jena Seymore, PMMC Director of Revenue Enhancement. 

Ready to transform your revenue recovery strategy with RecoveryAITM? Contact PMMC today to schedule a demonstration.  

About Brian Kenyon

Brian Kenyon oversees and manages the daily operations for PMMC's Business Intelligence division. He has over 8 years of experience in healthcare revenue cycle and business intelligence.