MedEvolve is encouraging hospitals and clinics to reassess their approach to the evaluation of the success of AI in revenue cycle management (RCM) and is making the claim that automation should be assessed based on how reimbursement is affected rather than how many tasks are finished. As the utilization of AI has gone on to rise in areas like coding, claims processing, eligibility verification, and billing processes, the company cautions that automating inefficient processes could result not in financial improvements but in denial increases, more reworks, and administrative costs.
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“None of those metrics ask the only question that matters: Did this action get you paid?” “Automation that doesn’t answer that question doesn’t remove the tax. It just makes mistakes cheaper and faster to produce.” Said David Henriksen, CEO of MedEvolve. MedEvolve came up with a result-oriented model to tackle the problem. Metrics included under the system are touches to resolution, avoidable administrative effort, denial-related workload, payment outcomes, and total cost to collect. The company claims that the healthcare organizations focusing on reimbursement outcomes rather than just keeping operational activities going are more likely to reduce costs, boost margins, and extract the maximum value from AI-driven revenue cycle automation.
