Healthcare business analytics specialist VisiQuate has teamed up with Etyon Health to develop a suite of revenue cycle management (RCM) applications with artificial intelligence (AI) technology.

WHY IT MATTERS

The partnership combines VisiQuate's AI and business analytics platform with Etyon’s deep machine-learning algorithms engineered to improve operational insights and automate complex data science claim decisions.

The aim is to accelerate time-to-insight, improve the accuracy of operational decisions and reduce cost-to-collect through integration of complex data, which are then presented as role-personalized insights and actionable workflows.

[See also: Hospital revenue cycle is ripe for modernization, but faces challenges.]

Etyon’s algorithmic engine approach is designed to optimize revenue cycle technology workflow business rules, standardize decision making for enterprise-wide revenue cycle reporting and analytics.

The algorithms can help reduce human dependency to combine and correct data, intelligently map data, spot anomalies, and make smart recommendations.

Another aim is to help redesign central business office revenue cycle processes by reducing overlap in redundant manual tasks, with algorithmic engines that can be specifically tailored to an organization.

The algorithmic engines also refine claims data that existed before, adding new attributes and predicting attributes before they happen.

Embedded intelligence allows information to be used across platforms such as Epic, Tableau, MicroStrategy and, since Eyton’s algorithms don't have a user interface, the company said it’s possible to interoperate insights to make other systems smarter.

THE BIGGER TREND

Healthcare organizations are undergoing a cultural shift that dramatically alters their approaches to patient intake, eligibility verification and claims processing.

Fee-for-service is going away and bundled payments will come to fruition, and adapting to this change means physicians must become educated on tracking quality metrics and reporting them to payers.

This means healthcare organizations increasingly require sophisticated analytics to perform a deep dive into their information and look at the margins for ancillary services provided.

This stretches from what is being collected in total from patients and payers for performing labs to injectables versus the cost to offer them.

VisiQuate and Eyton aren’t the only players in the field. Earlier this year Recondo Technology announced an RCM tool that uses AI to leverage Epic’s electronic health record to reduce the risk of denials and increase collections at the point of service.

Recondo’s capabilities include patient demographic verification, real-time eligibility and authorization and benefits normalization alerts management for denial risk reduction.

Nathan Eddy is a healthcare and technology freelancer based in Berlin.

Email the writer: nathaneddy@gmail.com

Twitter: @dropdeaded209 

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