Artificial Intelligence’s First Application in Collections Yields Groundbreaking Results
In what is the first commercial application of machine learning in outpatient rehab, Systems 4PT has harnessed Artificial Intelligence, (A.I.), to counter the bleak collection realities that define the current state of healthcare.
Systems 4PT integrates scheduling, EMR, billing, outcomes reporting and MIPS submission in one, single database. Since 2013 we have been data mining, by payer, collection activity for our nationwide outpatient rehab customers.
“The Industry” has it Wrong:
Industry-wide, the common perception is that “Payer mistakes are a high-frequency fact of life”. This is not the case. Your payers are not adjudicating your claims with armies of sloppy employees. They’re using “supercomputers”. And their results are “super consistent”. Yes, payers do make mistakes. But payer errors are vastly outnumbered by errors resulting from manual, human-based claim creation in the practice: Incorrect/incomplete data, or failure to respond to changes in payer rules.
Changing the Paradigm to Improve Collection Outcomes:
The solution is to arm your practice with a “supercomputer” of your own. Systems 4PT’s technology continually monitors every claim, for every payer and every patient in your region. In this fluid process, machine learning establishes ever-evolving “Payer Norms”. Systems 4PT’s technology concurrently monitors every claim in your practice, looking for aging characteristics that violate these up-to-the-second payer norms. When outliers are identified, the computer tells the Account Manager to engage.
The computer tells the human, which claims to work, and when.
It’s A LOT easier to correct a problem 15 days after signing the note, vs. 60 days. The fact that unpaid claims are corrected far before they are 30 days past due explains why Systems 4PT’s collection cycle (DSO) averages 18 days, nationwide. Our collection cycle is half of the 36-day DSOs advertised by the next-best billing software.
Leveraging artificial intelligence in the collection process has yielded inspiring results in an otherwise dismal payment landscape. We measure before and after collections metrics with every practice installation:
Practices Who Install Systems4PT Collect an average 9.2% More Per Visit,
Vs. Their Prior Approach to Billing