Along with everything else it can do, Artificial Intelligence will save you millions.

We thought that might get your attention, but according to a recent article at HealthLeadersMedia, it’s true.

South Dakota–based health system Avera Health used AI-powered automation to follow up on the status of outstanding claims, which resulted in $20.6 million in accelerated cash flow within 18 months of implementation

Previously, said Mary Wickersham, Avera’s vice president of central business office services the revenue cycle staff at worked tirelessly to manually follow up on outstanding claims, but they never seemed to get anywhere.

But “by automating claim status follow up, we’ve been able to discover and resolve claims set for denial more quickly and accurately."

Moreover, the organization has “seen a $1.1 million net impact in timely filing improvement and $260,000 in FTE annual savings, based on what it would have cost Avera to add additional staff to process the growth in claims instead of automating claim status follow up.”

As Wickersham sees it, "The sooner you know a claim is going to be denied, the better chance you have at adjudicating that denial. You have fresher information to work with and there is less investigating and digging you have to do. On the other hand, the longer a claim goes unresolved, the more … likely that you won’t be able to resolve it."

Following up on claims also reveals important revenue cycle patterns that can help determine root causes of denials, uncover which insurance companies reimburse more slowly, and understand which claims are reimbursed more slowly.

And, said Wickersham, following up on claims also helps patients. "You certainly don’t want to create added stress for recovering patients by involving them in a convoluted claim issue. That is something that all healthcare financial leaders should heed.”

In addition to the accelerated cash flow, costs savings, and increasing revenue, the automation process has resulted in several additional improvements:

    •    Average days in AR reduced by 7 days

    •    Average AR over 90 days reduced to 8%

    •    Timely filing write-offs as compared to net revenue down from 0.9% to 0.4%

    •    Number of accounts needing follow up per FTE down from 719 to 339

Plus, Wickersham noted another important improvement: staff morale.

"[C]laim status queues are shrinking, work goals are being met, staff is working on more challenging and interesting claims instead of going through repetitive hoops," she said.