How Will AI Improve on Revenue Cycle Management for Healthcare in 2025?

This year, our annual predictions focus on how AI in revenue cycle management (RCM) could help solve some of the most pressing challenges in the healthcare industry. As healthcare providers face increasing pressures from payers, shifting government regulations, and the need to meet patient demands while maintaining financial stability, AI-driven solutions are set to play a pivotal role in optimizing RCM efficiency.

When we look at RCM, we see opportunities for AI to make an impact across several areas: patient check-in, insurance verification, pre-authorization, billing and coding, claims processing, patient payment collections, and addressing insurance denials.

HealthIT Answers asked the experts what we might see in AI innovations for RCM in 2025. Here is what they had to say. And check out all their prediction posts looking to 2025

Visit our Tech-Enabled Solutions page today to discover how TruBridge’s solutions can help you optimize your revenue cycle management and prepare for the future of AI in healthcare.

Healthcare providers face intense pressures from payers and shifting government regulations to meet patient needs and ensure financial stability. RCM must integrate with the EHR to improve patient care and ensure accurate coding, billing, and collections. With TruBridge nTrust, you can optimize this integration, streamline processes, and use AI to boost efficiency across both back-office and clinical teams.

Looking ahead to 2025, Patrick Murphy, MBA, FHFMA, General Manager at TruBridge, anticipates three core areas of focus for AI in RCM:

• Real-time analytics: Continuously updated information on payer behaviors and nudges to help staff prioritize tasks.
• Vetted data models: High-quality, unbiased data is critical to building AI systems that reduce administrative complexity instead of adding to it. Learn how healthcare executives are investing in AI to improve their revenue cycles in this insightful post on health executives investing in AI.
• Third-party validation: Peer-review by industry associations and coalitions must be a top priority. Designations like HFMA peer review is a valuable place to start the search for vetted RCM tools.

Patrick Murphy, MBA, FHFMA, General Manager, TruBridge
LinkedIn: J. Patrick Murphy, MBA, FHFMA

2025 brings continued opportunities to fine-tune new technology and go beyond theorizing about AI to practically using these tools and proving success. To further explore how automation and AI technologies are being leveraged to transform healthcare operations, we highly recommend visiting our comprehensive resource on transforming healthcare operations through RCM automation.