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Why RCM Companies Are Modernizing Their Environments
According to Experian Health’s 2024 State of Claims survey, 77% of healthcare finance and operations decision-makers say payer policy changes occur more frequently, and 73% say claim denials are increasing (up more than 10 and 30 percentage points, respectively, since 2022). Claim errors and reimbursement times are also growing. While multiple factors are at play, the survey found that two of the biggest are a lack of automation and insufficient data analytics.In the complex landscape of U.S. healthcare, revenue cycle management solutions help providers navigate these and other challenges to optimize financial operations. The industry is evolving quickly and poised for significant disruption as RCM companies adopt artificial intelligence, robotic process automation and adaptive learning, says Landon Tooke, COO and chief compliance officer of Impact Healthcare Solutions.
Medigy Insights
Adam Robinson, vice president of platform engineering for RCM company FinThrive, says advanced solutions give providers the benefit of AI and machine learning without having to build those capabilities internally. Given the financial challenges facing healthcare, he says, providers need better ways to navigate payer processes.“Our customers are under constant pressure in terms of their costs and being able to recover costs from insurance carriers, who have increasingly complex rules,” Robinson says. “Being able to take advantage of machine learning and AI to make people more efficient is a big area for us, so we can allow our customers to invest in areas that aren’t RCM, such as patient care.”
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