A new artificial intelligence-based application promises to reinvent the revenue cycle for healthcare organizations. It has built a “digital employee” that can recognize vulnerabilities in an organization’s revenue cycle and reduce errors impacting profitability.
Trusted Revenue Innovation for Smart Healthcare, or TRISH, will analyze the areas of the revenue cycle that are most problematic for healthcare organizations, including eligibility, authorizations, pre-certification and claims status.
TRISH is the result of SHOAR Health, a joint venture between accounting and consulting firm Healthcare Advisory Group of Windham Brannon and Deep Indigo, a data science firm with proven success delivering artificial intelligence and machine learning solutions across multiple industry verticals.
SHOAR says TRISH can reduce the administrative burden without human intervention, learn and adapt as new variables are introduced and ensure accurate reimbursement.
“The revenue cycle is extremely rigorous,” said Windham Brannon Healthcare Practice Leader Valerie Barckhoff. “HIPAA laws back in 1996 gave us an outline for how to communicate the pieces back and forth, but healthcare organizations still struggle to manage the data. Reducing errors and inefficiencies can ultimately reduce the cost of doing business for healthcare organizations, increase revenue, and allow hospitals to focus on taking care of patients.”
In healthcare organizations, key areas that create revenue leaks include:
1. Poor front-end data
2. Missing or delayed referral
3. Missing prior authorization
4. Ineffective use of billing edits
5. Lagging collection times
6. Inconsistent follow-up
7. Poor denials management
TRISH promises to correct and automate the associated workflow and free staff to pursue higher-value efforts.
SHOAR is actively implementing TRISH in select client environments and can deliver TRISH to interested organizations regardless of size or geography. Implementation involves a comprehensive workflow analysis and customization of machine learning tools to meet the specific requirements of a client’s unique workflow needs.