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

This year our annual predictions will include some topics that look at how AI could help solve the challenges in our healthcare system. We begin with AI in Revenue Cycle Management. When we look at RCM we can identify these areas; patient check-in, insurance verification and pre-authorization, billing and coding, claims, patient payment and collections, to 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

Healthcare providers face intense pressures from payers and shifting government regulations to meet patient needs and ensure financial stability. RCM must be integrated with the EHR to optimize patient care and support accurate and timely coding, billing, and collections. AI will continue to improve each step for back-office and clinical teams.

In 2025, I anticipate 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.
• 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.

2025 brings continued opportunities to fine-tune new technology and go beyond theorizing about AI to practically using these tools and proving success.

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