How Artificial Intelligence Is Optimizing Revenue Cycle Management

The transactional nature of prior authorizations makes it ripe for automation, Seidman stated. But electronic adoption of prior authorizations remains low, according to data from the Council for Affordable Quality Healthcare, Inc. (CAQH).

Prior authorization is one of the best use cases for artificial intelligence in healthcare right now. The transactional nature of prior authorizations makes it an ideal candidate for AI technology, which can leverage real-time analytics and machine learning to identify cases needing prior authorization, submit requests to payers, and check statuses.

But prior authorizations are just one of the burdensome processes in a transaction-heavy part of healthcare: the revenue cycle.

This makes revenue cycle management very difficult to scale, especially for large organizations. According to Polaris, the only real way to achieve scale without the right technology is “to hire really smart people, and make them work even harder, and get even smarter.”