Optimizing Medical Office Operations in the Age of Artificial Intelligence

Registry and Electronic Health Record Data (EHR) Comparison for Real-World Evidence Generation

In the modern era of artificial intelligence, medical practices are confronting numerous obstacles to managing both their front- and back-office operations, obstacles such as:

• Coding errors
• Claim denials and payment delays
• Administrative overload
• Lack of patient engagement

These and other obstacles interfere with your practice's primary, and most important, goal: that is, providing exceptional care for your patients.

However, artificial intelligence (AI) presents a transformative opportunity for today's medical practices. By leveraging AI's strengths-such as automation, data analysis, and pattern recognition-healthcare practices can streamline their workflows, improve practice efficiency, and, ultimately, dedicate more of their resources to serve patient care.

Leveraging AI to streamline the revenue cycle management process

Medical coding

Medical coding is a critical step in revenue cycle management, the point where physicians or practice staff translate a patient's diagnoses and procedures into standardized alphanumeric codes for insurance billing. Mistakes in coding can result in the denial of the associated insurance claim or, minimally, delays in reimbursement. For this reason, coding errors are likely to lead to lost revenue.

However, AI-powered coding software can be used to automate the process of assigning medical codes to specific diagnoses or medical procedures. The AI software analyzes patient data and natural language processing in order to suggest the most accurate codes to use. This minimizes the risk of human error in the process and reduces the number of claim denials.

Predicting/mitigating claim denials

Of course, claims can still be denied by insurance companies even if the most careful coding processes were utilized. Claims can also be denied because they are missing information or due to contractual disagreements. Appealing denied claims is a time-consuming process and frequently leads to further delays in receiving reimbursement.

AI algorithms can help combat claim denials by analyzing historical claims data to identify patterns associated with denied claims. This analysis allows healthcare practices to identify potential issues with a claim proactively, before the claim is submitted-which saves both time and resources that would otherwise have been required by the appeals process. AI analysis can predict which claims are most likely to be denied, which prepares practices to focus efforts on collecting payments upfront from patients with these high-risk claims.

Leveraging AI to streamline other aspects of practice operations

Reduce administrative overload

Medical staff are often required to spend an excessive amount of their time performing administrative tasks, such as scheduling appointments, managing patient records, and handling prior authorizations from insurance companies-but this time could be put to better use providing direct patient care.

The ability of AI to automate a broad range of tasks enables practitioners to offload much of their administrative burden to AI-powered programs. For instance, AI-powered virtual assistants can handle administrative tasks such as scheduling appointments, sending out appointment reminders, and addressing basic patient inquiries. This frees staff to spend more of their time directly assisting patients. AI can also be used to automate tasks such as prior authorization requests and insurance eligibility verification. This allows AI to streamline practice workflows and reduce administrative clutter.

Improve patient engagement

In order to operate smoothly, a medical practice needs to be able to communicate effectively with its patients. Despite this, many practices struggle to maintain clear patient communication-which leads to confusion over billing, missed appointments, and other communication-based problems.

However, AI can eliminate many of these problems as well. AI-powered chatbots can provide patients with 24/7 access to appointment scheduling, prescription refills, answers to FAQs, and more. AI can also help personalize patient communications by sending patient-specific appointment reminders, medication adherence checks, and educational materials relevant to the patient's specific needs.

Veradigm's Predictive Scheduler addresses appointment management challenges

Veradigm's AI-powered Predictive Scheduler harnesses the power of AI to help address appointment management challenges such as missed appointments and the inefficient use of resources. The Predictive Scheduler can help a practice optimize its efficiency by automating scheduling and other tasks, which frees up valuable staff time for other essential responsibilities. The scheduler's ability to help high-need patients to be scheduled in a more timely manner helps to improve the overall quality of patient care. The resulting schedule has a positive impact on the practice's revenue cycle management because the optimized appointment slots result in fewer cancellations and fewer no-shows for appointments.

Veradigm's Predictive Scheduler also enhanced physician satisfaction by creating more predictable schedules for the medical staff as well as reducing the overall administrative burden associated with scheduling patient appointments.

Learn more about how AI can help optimize operations at your practice

To learn more about how AI can help optimize operations at your medical practice, download our whitepaper: "Optimizing medical office operations in the age of artificial intelligence." This paper reviews the most common revenue cycle management and practice management struggles faced by today's healthcare practices and explains how each of these challenges can negatively impact a practice's operations and its financial health.

This whitepaper also explains how AI can solve each of these issues by automating various steps in the processes, improving accuracy, and using data analysis to predict hurdles such as which claims are more likely to be denied. Download the whitepaper today-and learn some of the many ways that AI can help revolutionize your medical practice management from its revenue cycle to patient scheduling and beyond.

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