Transforming the Healthcare Revenue Cycle with Artificial Intelligence: A Guide to Building Impactful AI Using Electronic Claims and Electronic Health [Paperback]

The book begins with providing an overview of key concepts such as data science, machine learning, AI, language models (such as ChatGTP) and more.?Then the author expands up the defined process in the context of common revenue cycle use cases that leverage electronic claims and electronic health records.

1. What Is AI and Machine Learning. 2. Common Algorithms for Revenue Cycle Use Cases. 3. Other Modeling Categories. 4. Model Development Process. 5. Revenue Cycle Process Overview. 6. The Healthcare AI Process. 7. The MVP Process for Healthcare AI. 8. Post MVP Process for Healthcare AI. 9. AI in Healthcare Teams. 10. Big Data for EHR and Claim Data. 11. Production Deployment, Privacy, Security, and Key Issues.

Revenue cycle management (RCM) refers to an institutions financial management process that helps track, identify, collect, and manage incoming payments. This process helps businesses foster financial transparency within the company and charge patients the correct amount for the services they receive. But because of the unique healthcare payment system in the United States, relatively few of these dollars change hands directly between providers and their patients. Instead, there is a complex reimbursement system, mostly driven by third-party payment transactions between government programs and insurance companies, on the one hand, and healthcare providers, on the other.

Artificial intelligence (AI) can help predict claim denials by analyzing past denial trends and alerting health information management (HIM) professionals of potential denials in advance of billing. This affords an opportunity to review and correct claims pre-bill. One major benefit of AI in RCM is increased efficiency. By automating routine tasks, healthcare organizations can free up staff to focus on more important and value-added work. This can lead to improved productivity and faster turnaround times, ultimatel#ó