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Earlier this year, the ImagineSoftware team had the privilege of joining nearly 1,000 attendees at the 2023 Executive War College in New Orleans. Along with a host of the pathology industry’s pre-eminent pathologists, laboratory administrators, executives, consultants and other professionals, we had the opportunity to learn about the trends and challenges affecting the industry and the importance of addressing them for future operational and financial success.

Recently, Rob Gontarek, Senior Vice President of Data Science here at ImagineSoftware™, hosted an industry webinar to discuss articulating artificial intelligence (AI) in healthcare. Rob’s an expert with an impressive background in AI technology, dedicated to demystifying AI and better helping others understand how it works from a technical standpoint. During his presentation, Rob delved into the software and technology associated with revenue cycle management (RCM), customer relationship management, and more, focusing on how Imagine is evolving AI applications for advanced billing and revenue operations.

Artificial Intelligence (AI) and Natural Intelligence (NI) are two different types of cognitive processes and both are paramount within healthcare business operations. As the utilization of AI becomes more accessible, many medical billing and administrative teams are left questioning their jobs’ longevity. The truth of the matter is artificial intelligence-fueled billing systems rely on, and perform best, with human interaction/intelligence, or Natural Intelligence.

RadNav, ImagineSoftware’s radiology workflow automation solution, is on a mission to reduce the number of referrals that go unnoticed and illnesses that go undiagnosed due to missed appointments – having a huge impact on both patients and healthcare providers. "The reason this exists is because we saw a problem in health care, not just in radiology, but really across all of health care. One out of every two patients today are not receiving appropriate follow-up care. That's 50% of patients that are given a recommendation to do something by their doctor who are not doing it for one reason or another."

Rising health insurance deductibles and out-of-pocket costs are prompting more and more patients to realize they’re the new payer. According to Healthcare IT News, “The balance of billing revenue has shifted significantly, with patients now accounting for 30 percent of healthcare revenue on the back end.” In turn, healthcare providers are increasingly focusing on strategies and tools to promote patient payments/engagement. There’s not a one-size-fits-all method for achieving this, but there are ways to humanize patient engagement to ensure these individuals don’t feel like just a number

The Centers for Medicare and Medicaid Services (CMS) recently published the Calendar Year (CY) 2024 Medicare Physician Fee Schedule (PFS) proposed rule on July 13, 2023. Stakeholders can comment and provide feedback within a 60-day window, with the proposed rule scheduled to be finalized by November 1, 2023, after review of submitted comments by CMS.

Futuristic technology is taking the world by storm, especially within the healthcare industry, from ChatGPT writing your next speech to Artificial Intelligence-based algorithms identifying early diagnosis of patients. (Disclaimer: ChatGPT was not used to write this blog.) The medical billing industry is no different, undergoing a major shift from manual tasks to adopting automation software and artificial intelligence (AI), creating an array of opportunities for healthcare providers to optimize their revenue cycle

Today’s healthcare professionals face traditional point-solution technologies for billing tasks, such as claims processing, denial management, and patient payments. However, as Bain & Company notes in their latest Healthcare Provider IT Report, the “tech stack” of poorly integrated software solutions is driving many organizations to refocus on “all-in-one" systems.

What seems like routine, annual wellness visits can quickly become a burden for many patients. From unmet health insurance deductibles to increasing prescription drug costs, more and more patients are skipping “wellness” appointments to avoid medical bills; which unfortunately contributes to the 131.3 million emergency department visits per year, and possibly an even bigger bill in the end.

Medical Revenue Cycles are responsible for bridging the gap between effectively reimbursing physicians for their care and elevating patients’ experiences from check-in to bill-pay. Medical bills must be accurate, compliant with regulations, and timely to ensure that patients receive proper care and that medical facilities receive adequate reimbursement. Unfortunately, several key issues can arise when it comes to medical billing in revenue cycle management (RCM) processes, negatively impacting efficiency, accuracy, and patient satisfaction.