CON103: Revving up RCM with AI and Automation for a Lean Workforce

Eligible for: ACMPE: 1 | ACHE: 1 | CEU: 1 | CME(AAPC*): 1 | CPE: 1.2 | PDC: 1
Traditional | Intermediate | Analysis
* This session is included in the 2025 MGMA Summit education program.

Automation is increasingly important as healthcare organizations strive to reduce the cost to collect. While achieving a lean approach to collections begins with an understanding of how effective staff are in their work, most financial executives lack visibility into fundamental metrics such as the number of “touches” a claim receives before it gets paid. Without an understanding of where and when touches happen, the answer often is to throw more bodies or even bots at challenges. Discovery Behavioral Health, a nationwide network of treatment centers, recognized that this approach is not sustainable. What revenue cycle leaders really need is to empower staff to work smarter and reduce the amount of manual work. This presentation will explore the organization’s journey implementing an infrastructure built on workforce automation and intelligent analytics that holistically addresses the full lifecycle of revenue cycle processes — from front-end registration to back-end billing and collections — across its hundreds of facilities. Participants will learn how Discovery Behavioral Health’s approach — drawing on the power of lean manufacturing principles — has realized a 5.2% improvement in cash flow, created 30% more capacity in its revenue cycle team and benefitted from a 13% improvement in zero-touch rates, a key performance indicator that illustrates the percentage of claims that get paid without any human intervention.