By Jeffrey DiLiddo

Big Data in healthcare is exploding. A recent report published by Seagate projects that healthcare data will experience a compound annual growth rate of 36% by 2025 , and that data sphere is expected to grow 13% faster than other industries.  The report goes on to state that “hypercritical healthcare data” is expected to more than double every other year.  Those are some compelling numbers.

The phrases “big data”, “machine learning” and “artificial intelligence” are everywhere.   I just saw a commercial for a mattress that now comes with “AI”.    The reality is that there’s a lot of marketing buzz around these words right now.   Many managers and executives do not have a true picture of what these data solutions actually do, and how to apply them to their practice. Currently the majority of machine learning and AI development has been focused on clinic operations, decision support, and consumer/patient engagement.

But who has their eye on Revenue Cycle data that can be used to improve efficiencies, cut costs and increase collections?    The clinical operations teams are getting access to bleeding edge technology while the billing team is left in the basement to print reports and work out of spreadsheets.  It’s critical that your team understand the difference between technologies such as Robotic Process Automation, Rules Based Workflow Management, Machine Learning, and Business Intelligence. It’s equally important to learn how they apply to your Revenue Cycle management efforts. Furthermore, it’s important to identify the “hypercritical” billing and revenue cycle data in your practice so that you can put it to work for you.

Here are the Top 5 ways data can improve your Revenue Cycle


1 – Visibility paves the way for decision making

When I ask CEOs, CFOs and Billing Managers “what are you missing” they all reply with one word… “visibility”.  When the billing/RCM manager doesn’t have easy access to the information the CFO needs, everyone gets stressed. In my experience, the billing manager knows what’s keeping them from hitting their targets, they just cannot accurately quantify it. Critical decision making relies on the ability to quantify issues and successes so the whole team can focus.  With easy to access data, they can go about the process of fixing systemic billing issues and improving performance, instead of spending all their time running reports.

2 – Automate the process of identifying just the actionable work for your team

You’d shudder to know how many places your claims could get hung up in the revenue cycle.  Your billing team spends too much of its time just digging through piles of denied claims to find their work.  Much of their day is a tedious journey through endless work queues, edit lists, spreadsheets and reports.  These days advanced algorithms have the ability to sift through this mess automatically, giving your team the most important work right away. Billing team members get the freedom to dive into their work rather than spinning their wheels. When armed with the data they need, billers become more productive and will work more claims. Advanced workflow solutions can not only help identify the most actionable claims but can automatically shuffle everything else out of their way.

3 – Give your team feedback on what’s working and what’s not working

Working in Revenue Cycle Management and can be frustrating work.  In the end, if there’s a claim on your desk, it’s a pretty good bet it’s not paid.  Someone made a mistake somewhere.  Billers spend all day long looking at what went wrong.   What if you gave them a way to see all of the great things that they’d done right?   I was speaking to some billers in New England last week and when I told them we could show them every claim they had worked that had resulted in a payment… they beamed.  A tenured billing expert is a huge asset to your team.  It can take a long time to learn the ins-and-outs of your payers, specialty, providers, etc., so giving them the tangible, positive results of their work every day might just keep them in your employ!

4 – Eliminate frustration and wasted time in the clinic

If you asked them, every single one of your providers or clients would tell you that they would like to spend less time working on “billing”. Your front desk team and providers need actionable data.  Their mistakes cause rework all the way down the line in your revenue cycle.   Eventually, it’s likely that you’re going to have to go back to them requesting the information you didn’t get the first time.  In the end, everyone ends up frustrated.  Revenue cycle analytics tools isolate the source of those denials, giving you the opportunity to train and inform your front end constantly. If they knew the mistakes they were making the first time around and how to prevent them, it would lighten the load.

5 – A healthy revenue cycle will improve the patient experience

You can have world-class healthcare delivery, but if the patient “suffers” during the billing process, it will take over their perception of your practice.   I recently spoke to some friends whose son was recovering from ACL surgery.    When asked about the company that provided the post-op equipment they replied, “They are the worst!“. They went on to tell me that the clinical team and brace fitters were amazing, but when it was time to get the bill, things really went south.  Frustrated with erroneous bills that were caused by avoidable mistakes, they described the process as “horrible”. It completely changed their perception of that company.  In the world of social media, 1-star reviews and increasing consumerism in healthcare, a healthy revenue cycle matters

In Summary

Technology and data can have a profound effect on your cash collections performance and help you reduce costs. Empowering your team with information that is tailored to to their needs frees them to focus on what’s important. The right revenue cycle technology purchase can have a significant ROI for your practice (or clients).   Perhaps more importantly, making technology decisions that improve the revenue cycle will improve health care delivery as a whole.

About Us

RevenueHealth was born from decades of experience in Medical Billing and Revenue Cycle Management (RCM). We’ve developed tools of the trade used by RCM experts to provide industry leading revenue performance metrics across multiple specialties in private practices, community health centers, and large teaching hospital health systems. Those “tools of the trade” are now being offered to the healthcare industry as a whole. RevenueHealth is the beneficiary of nearly three decades of RCM billing business intelligence and expertise.