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What is the future of a Medical Billing and Practice Management Software with the advent of Artificial Intelligence?

Artificial Intelligence is changing the way businesses operate these days. It is changing consumer expectation and revealing a world where manual work is deemed redundant. This technological advancement has impacted the Healthcare IT industry as well. Digitization of Medical Billing Processes and technological advancement in RCM systems have taken the industry to a whole new level of optimization.

To discuss the impact of AI on a Medical Billing and Practice Management Software, first let’s look at how a good Medical Billing and Practice Management Software functions?

Functions of a Medical Billing and Practice Management Software:

1. Scheduling for patient appointments

With machines learning technology, Medical Billing and Practice Management Software will not just be scheduling appointments with prompt patient reminders but will learn seasonal trends foretelling the patient footfall. Imagine the proactive preparation it can enable the doctors, with natural or man-made calamity/disasters/diseases. It will itself calculate successful appointments and draw conclusions as to how to avoid miss communications between patients and staff. One thing is for sure, it will render the job of a receptionist obsolete.

2. Patient Eligibility Checks

Artificial Intelligence, with its unlimited connectivity access, will not just be verifying (within minutes) whether the patient is eligible for insurance or what providers will cover the medical service cost but will draw efficient reports on the claims that can be rejected due to eligibility issues, with an action plan to avoid this from happening in the first place. It will also proactively contact the providers as well as alert the Medical Billing Company regarding the upcoming issues on patient eligibility. More so, learning the trends specific to each patient/provider will help reduce such errors to 0%.

3. Scrubbing for coding errors

The ability to self-learn will enable Medical Billing and Practice Management Software to avoid coding errors. At present scrubbers can be manually fed with codes reducing the chances of denials significantly. Imagine the efficiency AI will instill when the scrubbers can-not just self-learn but proactively correct the errors before submitting claims.

4. Claim Tracking

At present, many Medical Billing and Practice Management Software are able to present a dashboard view of the number of claims submitted, denied, stuck, pending payment etc. An expert help is required to draw insights as to why the claims are denied or the reason for them being stuck or rejected. With Machine learning capabilities this need for manual assistance will no longer be required. The software itself will be able to draw effective insights with proper action plans as to why an issue occurred and how can it be corrected, more so with menial issues it would take the lead and get the reimbursement.

5. Reports

Basic reporting mechanism is there with many good Medical Billing and Practice Management Software, providing ad hoc reports that can be customized as required. With AI, however, reports will not just be mere activity tracking but strictly RCM performance analysis. NLP techniques will enable the software to cumulate data drawing insights that can help business take proactive management/directive decisions. It can highlight problems in RCM processes with ways/means to resolve them. Imagine being able to get efficient support with administrative/operative/financial decisions, even with decisions such as, should more staff be hired? Should Saturdays be on? Etc.

Benefits of having machine learning techniques for a Medical Billing and Practice Management Software:

  • Automation of the coding process will reduce the need to hire skilled professionals for the job, saving both time and cost
  • By omitting the need for manual work, it will help optimize the work hours improving the quality of work
  • Automation will eliminate costly human errors with minimum data entry required. It will also enable efficient integration with other supportive software like EHRs or LIS providing an effective RCM solution.
  • Proactive error management with thorough performance audits will eliminate high risk/cost problems to occur, optimizing the claim management process.
  • Automation of repetitive menial tasks will enable professional coders/billers to focus on more complex issues.
  • Unlimited connectivity with EHRs and easy data extraction facilities will enable quicker and error free patient payments.
  • AI will reduce the number of customer support queries lowering operating costs.
  • With the ability to self-learn with more tasks, the system will become more sophisticated over time and continue to narrow margins of error.

The era of Artificial Intelligence is wonderous, one can only imagine the magnitude of impact it will have on the Medical Billing and Practice Management Businesses on a whole.

AltuMED PracticeFit is a Medical Billing and Practice Management Software that optimizes the Medical Billing Process significantly. It is intuitive, cloud based, user-friendly and comes with the simplest pricing model with no hidden costs. PracticeFit is technologically advanced and incorporate AI in its systems. Have a look at the demo to learn more:

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