Impact of Artificial Intelligence on The Medical Billing World

It is still difficult to imagine the future of revenue cycle management in the age of artificial intelligence. By definition, Artificial intelligence (AI) – is intelligence demonstrated by machines, unlike the natural intelligence displayed by humans and animals, which involves consciousness and emotionality. Industry thought leaders are looking for a viable answer on how the day to day back office work in healthcare will be influenced by artificial intelligence. While nobody knows precisely when AI will be an industry standard, there surely a buzz around on its possible outcomes!

Streamlining work flow in Medical Billing

Using artificial intelligence to learn user’s habits; anticipate the demands and displaying the right data with a deep learning of interaction tendencies will drastically reduce the labor spent on the manual tasks with billing, allowing staffs make a better decision with the next steps of finding a resolution with the denials. Artificial intelligence looks to support workers, making their jobs a lot easier. By using synthetic data, based off real data, artificial intelligence can help workers by predicting what they want them to do. This generated data can help the machines to understand what to do, reducing the workload of the medical billing staff. Of course, artificial intelligence can do so much more also!


Improvement in accuracy with Medical Coding

One of the key features of AI will be the ability of analyze spoken word and text. Systems will be able to learn the procedure languages / diagnosis details for producing the accurate codes. It is quite easy to imagine how the transition from ICD-9 to ICD-10 would have been a cakewalk with the right use of AI! The capability of having a detailed impact on the after code set updates , with compliant documentation , reducing the transition time with coding updates is something which will be a must watch in the coming years.

Proactive Support in The Prior Authorization Process

Presently, it takes hours, days and a lot of time to obtain prior authorizations. Future systems will be able to analyze the health data of a patient and determine the medicalDME Billing Services necessity of a procedure within a few seconds. The capturing of the corresponding data, an automated process will be great for medical billers, eliminating pre auth denials due lack of proper documentation like the authorization number as an instance!

According to the CMS, the year of 2018 experienced a cumulative rate of improper payments of 8.12% or $31.62 billion! AI’s ability to analyze the information, take proper decisions. AI will be providing a perfect foundation to finding the cause of the denials, create prompts within the practice management systems for rectification.

Sunknowledge Services Inc: The Medical Billing Hub

Sunknowledge Services Inc is a complete medical billing Services Company. We offer stand alone/ end to end practice management/ revenue cycle management services to leading clients in the DME space. Our team has the ability to offer unparalleled support with a keen understanding of the best practices of the industry.

We deliver assistance in both pre billing/ post billing requirements in the DME/HME/ Orthotics & prosthetics segment on a stand-alone/ end to end basis. As a reliable operational arm, our team is proficient across all major billing systems like Brightree, Kareo, OPIE, Fastrack, CPR+ HME, TEAMDME and many more, offer seamless transition. Also, we are capable with any client proprietary platform and deliver according to your protocols.

Sunknowledge Services Inc currently serves the largest DME company in East Coast and extends its foot print to the Hawaii islands in the West. We currently more than a 100 clients in the DME space! We extend unique heavy lifting support in DME pre billing that drives your cash flow!

We offer you better visibility for the 2021 DMEPOS bid as we allow you to bid lower with an instant reduction of billing costs by 80%. We lay down strong checks and balances in DME pre medical billing that sets the benchmark for a complete RCM experience.

The Sunknowledge advantage :
? Exceptional productivity standards
? 80% reduction in current billing costs
? Dedicated account manager at no extra costs
? 100’s of excellent references
? $1 million Hiscox/Geico Insurance coverage for any errors of Omission & commission
? No binding contracts
? We bear all costs of transition during your migration from old vendor
? We can meet or beat any price/ Rates start at $7 per hour

Our DME pre billing services cover:
? Eligibility Verification – Online & Calling (with same & similar check for Medicare)
? Authorization Initiation – Online & Calling
? Authorization Follow Up
1. Follow-up with payer on Authorization
2. Completion of authorization form based on the outcome of the request
? Doctor’s Office Follow-up for documents etc
? Re-Authorization
? Order Entry
1. Patient Account Creation
2. Patient’s demographic entry
3. Prescription information entry
4. Insurance entry
5. Provider’s information entry
6. Item entry
? Order Confirmation
? Scheduling of Delivery

Post-billing Services:-
? Creation of Claims
? Claims Submission
1. Primary/Secondary/Tertiary claim submission (via paper/fax/electronic)
? Claim Rejection Management
1. Online rejection checking (via Clearing House)
2. Correction and resubmission of the rejected claims (via Clearing House)
? Payment Posting – Auto & Manual
1. Patient payment posting and adjustments
2. Insurance payment posting and adjustments
? Accounts Receivable & Denial Management
1. Follow-up on pending AR balance and working on denials
2. Follow-up on possible reconsideration requests
3. Filing reconsideration requests & appeals

Let us share with you a complete business plan on how we can work as your ultimate operational arm. Leverage the Sunknowledge excellence for a complete healthcare revenue cycle management experience!

Leave a Reply