Revenue Cycle Management (RCM) is hot topic right now due to the cybersecurity incident at Change Healthcare. Hear honest answers to tough questions related to that incident and how AI will impact RCM.
To explore this topic, Healthcare IT Today, wanted to ask an executive that works in this area to come on-camera for a “Three Tough Questions” interview. Michael Quinn, VP of Strategic Partner Development at Inovalon, graciously agreed to be interviewed.
Inovalon is a company that offers a platform that brings together national-scale connectivity, real-time primary source data access, and advanced analytics in a cloud-based platform. The company’s analytics capabilities are used by 53,000 sites of care.
Watch as Michael Quinn answers these three tough RCM-related questions:
- AI is the hottest technology at the moment. It is EVERYWHERE. But has AI made any meaningful improvement to the RCM process?
- Since RCM processes are so standardized, are we heading for a day when it will be completely automated and not require any people?
- What will change for the positive and what will remain the same after the Change Healthcare cybersecurity incident that has frozen payments in our industry?
AI Making Meaningful Improvements to RCM
In his response, Quinn highlighted the nebulous definition of AI. The science-fiction definition of AI that is human-like in behavior, is not real (yet). He is skeptical of these types of outlandish claims.
“However, AI that refers to data mapping, language, and analytics – that is something that can benefit healthcare right now,” said Quinn.
This more practical application of AI has Quinn excited and he believes that it will have a positive impact on RCM.
Human-less RCM Unlikely
According to Quinn, since many RCM processes are standardized and repeatable, they are a good candidate for automation, especially AI-enhanced process automation. Although Quinn believes that one day AI may automate many RCM processes, he does not believe this is something that will happen soon, nor does he believe that the entire process can be done with out human oversight or intervention.
“I don’t think we can ever, nor should replace human intervention,” stated Quinn. “We need human beings to be part of the process. The rules for payments are constantly changing and there are always exceptions that need to be handled uniquely.”
Positive Outcome from Change Healthcare Cybersecurity Incident
Quinn feels that one of the positive outcomes of the Change Healthcare cybersecurity incident is that organizations will now look more closely at how and where their data is routed.
“Healthcare organizations are re-evaluating being single-threaded through Change Healthcare,” said Quinn. “They now understand they need to have multiple paths for their data for business continuity reasons. They need to ability to route data traffic quickly in response to incidents and they cannot be reliant on a single pathway.”
Quinn is hopeful that governments may help to fund healthcare’s investment in redundant processing networks and cybersecurity, like they did to spur the adoption of electronic health records.
Learn more about Inovalon at https://www.inovalon.com/
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