Transforming Denial Management in Healthcare: The Role of Collaboration, AI, and Outsourcing

The disconnect between Accounts Receivable (AR) teams and their Information Technology (IT) counterparts in healthcare hinders effective denial management, with AR teams lacking technological tools and IT teams lacking practical AR insights. This leads to inefficiencies, as many organizations still use basic tools like Excel for tracking. AI can transform Revenue Cycle Management (RCM) by automating repetitive tasks, identifying denial patterns, and enhancing decision-making, thus reducing denials and improving efficiency. Combining AI with outsourcing solutions, such as Business Process Outsourcing (BPO), integrated AI and RCM services, and Human Resource Outsourcing (HRO), can optimize revenue cycle operations. Effective collaboration between AR and IT teams, integrating AI with outsourcing, and addressing job security concerns are crucial for successful denial management. This approach ensures that technological advancements align with operational needs, enhancing overall efficiency and financial outcomes.

About the Author

Liviu M Imbir is a seasoned revenue cycle executive with over twenty years of experience in both for-profit and non-profit organizations. As a customer service advocate and a patient-focused, performance-driven leader, he has successfully led and motivated teams of 200 to 500 members. His projects consistently result in increased revenues, reduced costs, and improved customer relationships, while also building strong leadership teams that sustain progress post-project. As a data-driven professional proficient with technology, he fosters a culture of trust, accountability, and growth, leading to top decile patient satisfaction and employee engagement performance.