{"id":7073706,"date":"2026-10-03T02:41:20","date_gmt":"2026-10-03T02:41:20","guid":{"rendered":"https:\/\/fivemor.com\/?p=7073706"},"modified":"2026-10-03T02:41:20","modified_gmt":"2026-10-03T02:41:20","slug":"four-ways-to-artificial-intelligence-and-automation-in-your-revenue-cycle","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=7073706","title":{"rendered":"Four ways to artificial intelligence and automation in your revenue cycle"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div>\n<div class=\"wp-block-experian-blocks-at-a-glance\">\n<section class=\"\" data-analytics=\"columns\">\n<div class=\"mb-40 row wp-block-columns\">\n<div class=\"is-layout-flow wp-block-column col-12\">\n<div class=\"wp-block-experian-blocks-wrapper exp-solid-bg--blue-100 rounded aag-container p-30 col-12\">\n<div class=\"wp-block-experian-blocks-wrapper row\">\n<p><h2 class=\"h6 text-uppercase\">At A Glance<\/h2>\n<p>Revenue cycle management automation and artificial intelligence (AI) can help healthcare organizations reduce manual work, catch errors earlier and prioritize claims that need attention. Learn how revenue cycle teams can use AI-powered tools like Patient Access Curator and AI Advantage to support more efficient workflows.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<\/div>\n<figure class=\"\" data-analytics=\"image\"><img decoding=\"async\" src=\"https:\/\/www.experian.com\/blogs\/healthcare\/wp-content\/uploads\/2024\/03\/Blog_RCMThreeUseCases_20260915.png\" alt=\"healthcare worker using tablet\" class=\"img-fluid shadow-none shadow-none rounded\"\/><\/figure>\n<p><strong><em>Key takeaways:<\/em><\/strong><\/p>\n<ul class=\"wp-block-list\">\n<li>Revenue cycle teams can use automation to reduce repetitive work and apply AI where data-driven prediction, matching or prioritization can improve a workflow.<\/li>\n<li>Experian Health\u2019s <strong><a href=\"https:\/\/www.experian.com\/healthcare\/resources-insights\/thought-leadership\/white-papers-insights\/state-claims-report\" target=\"_blank\" rel=\"noreferrer noopener\">2025 State of Claims survey<\/a><\/strong> found that 41% of providers now face denial rates of 10% or higher, while 68% say submitting clean claims is more challenging than a year ago.<\/li>\n<li><strong><a href=\"https:\/\/www.experian.com\/healthcare\/products\/patient-access-registration\/patient-access-curator\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Access Curator\u2122 (PAC)<\/a><\/strong> uses AI to support front-end data validation and insurance discovery, while <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage\u2122<\/a><\/strong> helps teams predict denial risk and prioritize denial follow-up.<\/li>\n<\/ul>\n<p>Artificial intelligence (AI) and automation can support administrative work in healthcare. In the revenue cycle, teams depend on accurate information, timely decisions and efficient follow-up to keep claims moving.<\/p>\n<p>In revenue cycle management, AI and automation can help organizations reduce manual checks, find data gaps, predict denial risk and prioritize work queues. These tools are most useful when they support staff judgment, payer expertise and compliance oversight. They can handle repetitive, data-heavy tasks so staff can focus on exceptions and decisions that need human review.<\/p>\n<p>In 2023, <strong><a href=\"https:\/\/www.mckinsey.com\/industries\/healthcare\/our-insights\/setting-the-revenue-cycle-up-for-success-in-automation-and-ai\" target=\"_blank\" rel=\"noreferrer noopener\">McKinsey &amp; Company<\/a><\/strong> reported that research suggests effectively deploying automation and analytics could eliminate $200 billion to $360 billion of spending in U.S. healthcare. For revenue cycle leaders, the practical question is where to apply those capabilities first.<\/p>\n<h2 class=\"h3\">The case for applying AI and automation in healthcare<\/h2>\n<p>Revenue cycle teams juggle many daily tasks. Staff collect and verify patient information, confirm eligibility, identify the right payer, submit clean claims, monitor status, work denials and manage collections. Small data gaps at the beginning of the process can create downstream rework and delays.<\/p>\n<p>Rework also consumes staff time, adding to these operational pressures. As costs rise and revenue cycles tighten, there is increasing pressure to do more with less. Experian Health\u2019s <strong><a href=\"https:\/\/www.experian.com\/healthcare\/resources-insights\/thought-leadership\/white-papers-insights\/state-claims-report\" target=\"_blank\" rel=\"noreferrer noopener\">2025 State of Claims survey<\/a><\/strong> found that 54% of providers say claim errors are increasing and 90% of claim denials are reworked with at least some human review before resubmission.<\/p>\n<p>Providers are also managing broader financial and administrative pressures. The <strong><a href=\"https:\/\/www.aha.org\/guidesreports\/2024-09-10-skyrocketing-hospital-administrative-costs-burdensome-commercial-insurer-policies-are-impacting\" target=\"_blank\" rel=\"noreferrer noopener\">American Hospital Association<\/a><\/strong> has reported that prior authorization requirements, claim audits, denials and other payer policies add administrative burden and cost for hospitals and health systems. These requirements also consume staff time to appeal denials and manage payer processes.<\/p>\n<p>AI and automation are different but complementary. Automation follows defined rules to complete repeatable work. AI models can identify patterns in data, predict risk and help teams decide where to focus attention. When used together, they can support more consistent revenue cycle workflows.<\/p>\n<h2 class=\"h3\"><strong>How AI and automation can support revenue cycle workflows<\/strong><\/h2>\n<p>Revenue cycle management automation and AI are most useful when tied to a specific workflow and a measurable operational problem. The goal is to help teams act earlier, reduce avoidable rework and focus staff time where judgment is needed most.<\/p>\n<p>For example, automation can complete rule-based eligibility checks. AI can help identify claims with a higher likelihood of denial. In insurance discovery workflows, AI can also help identify coverage that wasn\u2019t captured at registration. When these tools fit into existing workflows, they can support more consistent decisions and reduce manual work.<\/p>\n<p><strong>Three practical applications include:<\/strong><\/p>\n<h2 class=\"h4\"><strong>1. Improving front-end data quality with Patient Access Curator<\/strong><\/h2>\n<p>Patient and coverage information collected early in the revenue cycle can affect downstream claim outcomes. Incomplete or outdated demographic details, eligibility responses, coordination of benefits or Medicare Beneficiary Identifier information can create problems that lead to claim delays or denials later in the cycle.<\/p>\n<p>Experian Health\u2019s <strong><a href=\"https:\/\/www.experian.com\/healthcare\/products\/patient-access-registration\/patient-access-curator\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Access Curator<\/a><\/strong> helps prevent claim denials by validating demographics, eligibility, insurance discovery, coordination of benefits and Medicare Beneficiary Identifier data in seconds. PAC\u2019s AI and machine learning capabilities help improve match accuracy, coverage sequencing and data confidence by writing the validated data back into the host system and sequencing payers before the claim is created. This automates work that would otherwise require manual coverage checks.<\/p>\n<figure class=\"\" data-analytics=\"image\"><a href=\"https:\/\/www.experian.com\/blogs\/healthcare\/experian-healths-pac-earns-strong-early-feedback-in-2026-klas-first-look-report\/\" target=\"_blank\" rel=\" noreferrer noopener\"><img decoding=\"async\" src=\"https:\/\/www.experian.com\/blogs\/healthcare\/wp-content\/uploads\/2026\/06\/KLAS-PAC-Report-Stat-Image-for-Blog.png\" alt=\"2026 KLAS First Look report: Patient Access Curator\" class=\"img-fluid shadow-none shadow-none rounded\" style=\"width:764px;height:auto\"\/><\/a><\/figure>\n<h2 class=\"h4\"><strong>2. Using insurance discovery to find coverage not captured at registration<\/strong><\/h2>\n<p>When active coverage isn\u2019t identified during registration, claims may be delayed or submitted with incomplete insurance information. Insurance discovery looks for coverage that may not have been captured during registration.<\/p>\n<p><strong><a href=\"https:\/\/www.experian.com\/healthcare\/products\/patient-access-registration\/patient-access-curator\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Access Curator<\/a><\/strong> includes insurance discovery as part of its front-end validation workflow. It can help identify and correct missing or incorrect insurance information so claims can be submitted with more complete coverage data.<\/p>\n<h2 class=\"h4\"><strong>3. Using AI to prevent and prioritize denials<\/strong><\/h2>\n<p>Even with strong front-end processes, some claims still require additional attention. AI can help claims teams decide which claims to review before submission and which denials to work first after payer response.<\/p>\n<figure class=\"wp-block-table\">\n<table class=\"has-fixed-layout\">\n<tbody>\n<tr>\n<td>Experian Health\u2019s <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage<\/a><\/strong> supports two denial management use cases:<\/td>\n<\/tr>\n<tr>\n<td>1. <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage<\/a><\/strong> \u2013 Predictive Denials uses a client\u2019s historical claims data and Experian\u2019s knowledge of payer rules to identify claims with a high likelihood of denial before submission so teams can take corrective action.<\/td>\n<\/tr>\n<tr>\n<td>2. <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage<\/a><\/strong> \u2013 Denial Triage uses AI to segment denials and identify those with the highest potential for reimbursement.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n<p>This approach can help teams prioritize with more confidence. Rather than treating every claim or denial the same way, teams can use predictive models to focus on the work that needs the most attention.<\/p>\n<h2 class=\"h3\"><strong>Potential benefits of AI and automation in the revenue cycle<\/strong><\/h2>\n<p>A high-performing revenue cycle depends on timely, accurate and consistent work. AI and automation can help providers modernize that work without losing the expertise of the people who manage complex payer and patient situations every day.<\/p>\n<p><strong>When applied to the right workflows, these tools can help organizations:<\/strong><\/p>\n<ul class=\"wp-block-list\">\n<li>Reduce manual data searches that take staff away from higher-value work <\/li>\n<li>Improve front-end data quality before claims are created<\/li>\n<li>Identify missing or incorrect coverage information earlier<\/li>\n<li>Spot claims that may be at higher risk of denial<\/li>\n<li>Prioritize denied claims by potential reimbursement<\/li>\n<li>Reduce rework caused by inaccurate or incomplete information<\/li>\n<li>Give staff more consistent information for follow-up decisions<\/li>\n<\/ul>\n<p>A focused AI strategy starts with the workflow problem, uses data that is relevant to that problem and keeps staff in control of judgment-based decisions.<\/p>\n<section class=\"par-comp-mb wp-exp-media-text border--gray-10-outline\" data-analytics=\"media-text\">\n<div class=\"row align-items-center p-15\">\n<div class=\"wp-block-media-text__media col-lg-6 col-12\">\n   <a href=\"https:\/\/tei.forrester.com\/go\/Experian\/PatientAccessCurator\/?lang=en-us\"><img decoding=\"async\" src=\"https:\/\/www.experian.com\/blogs\/healthcare\/wp-content\/uploads\/2026\/09\/Blog_ForresterStudyPAC_20260922.png\" alt=\"Forrester Study banner\" class=\"wp-block-media-text__media-image shadow-none rounded\"\/><\/a>\n<\/div>\n<div class=\"wp-block-media-text__content col-lg-6 col-12\">\n<p>The Total Economic Impact\u2122 of Experian Health Patient Access Curator, a Forrester study commissioned by Experian Health, modeled fewer coverage-related denials and less manual discovery work for a composite health system when using PAC.<\/p>\n<\/div><\/div>\n<\/section>\n<h2 class=\"h3\">FAQs<\/h2>\n<p>   <!-- start Accordion --><\/p>\n<div class=\"exp-accordion par-comp-mb\">\n<div class=\"accordion\" data-analytics=\"accordion\">\n<div class=\"card border-bottom-0 border-right-0 border-left-0 rounded-0\">\n<div id=\"acf9ae610-a394-42ea-8323-3c8b098d97cf_acc_051129e1-d34f-4a04-8f65-88ea73783435\" class=\"collapse text-left\" aria-labelledby=\"acf9ae610-a394-42ea-8323-3c8b098d97cf_acc_051129e1-d34f-4a04-8f65-88ea73783435-heading\" role=\"region\">\n<div class=\"card-body pt-2 px-3 pb-3\">\n<div itemprop=\"text\">\n<p>In revenue cycle management, automation, machine learning and predictive analytics can support administrative workflows such as patient access, claims management and denial management. Automation completes repeatable tasks based on defined rules, while AI can identify patterns, predict risk or prioritize work based on data.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<div class=\"card border-bottom-0 border-right-0 border-left-0 rounded-0\">\n<div id=\"acf9ae610-a394-42ea-8323-3c8b098d97cf_acc_fed69862-b9c3-4ea6-a77d-a63cd1bcbbad\" class=\"collapse text-left\" aria-labelledby=\"acf9ae610-a394-42ea-8323-3c8b098d97cf_acc_fed69862-b9c3-4ea6-a77d-a63cd1bcbbad-heading\" role=\"region\">\n<div class=\"card-body pt-2 px-3 pb-3\">\n<div itemprop=\"text\">\n<p>Providers can start with workflows that are data-heavy, repetitive and tied to clear operational outcomes. Examples include validating front-end registration data, finding insurance information, predicting denial risk and prioritizing denials for follow-up. These are areas where better data and earlier action can reduce downstream rework.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<p>   <!-- end Accordion --><\/p>\n<h2 class=\"h3\">A more proactive approach to revenue cycle management<\/h2>\n<p>Revenue cycle teams can move from reactive work toward a more proactive approach: catch errors earlier, validate coverage before claims are created and prioritize the claims and denials that need the most attention. <\/p>\n<p>Experian Health offers revenue cycle solutions that use AI and automation in targeted ways to support front-end data quality, reduce rework and manage denials. <strong><a href=\"https:\/\/www.experian.com\/healthcare\/products\/patient-access-registration\/patient-access-curator\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Access Curator<\/a><\/strong> supports registration and coverage validation, while <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage<\/a><\/strong> supports denial prediction and triage.<\/p>\n<p><em>Learn more about Experian Health\u2019s <strong><a href=\"https:\/\/www.experian.com\/healthcare\/products\/patient-access-registration\/patient-access-curator\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Access Curator<\/a><\/strong> and <strong><a href=\"https:\/\/www.experian.com\/lp\/healthcare\/ai-advantage\" target=\"_blank\" rel=\"noreferrer noopener\">AI Advantage<\/a><\/strong>.<\/em><\/p>\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n<div class=\"row justify-content-center no-gutters par-comp-mb\">\n<div class=\"col-12 form-container exp-solid-bg--white p-0\">\n<div class=\"form-renderer form-renderer-block\">\n<div class=\"container\">\n<div class=\"row justify-content-center no-gutters\">\n<div class=\"exp-pseudo-grad-top-lg col-12 col-lg-8 form-container exp-solid-bg--white p-0 rounded shadow overflow-hidden\">\n<div class=\"form-wrapper px-20 py-25 text-left position-relative\">\n<div class=\"form-description\">\n<p class=\"h4\">Contact Experian Health<\/p>\n<p>Complete the form below to be connected with a member of our Sales team. For Customer Support, including password resets, please visit our <a href=\"https:\/\/www.experian.com\/healthcare\/client-services\/healthcare-support-phone-number\" target=\"_blank\" rel=\"noreferrer noopener\">Support page<\/a>.<\/p>\n<\/div>\n<div class=\"modal fade form-renderer-modal\" tabindex=\"-1\" data-analytics=\"modal\" role=\"dialog\">\n<div class=\"modal-dialog\">\n<div class=\"modal-content text-center\">\n<div class=\"modal-body\">\n<div class=\"aem-Grid aem-Grid--12 aem-Grid--default--12 \">\n<p><h2 data-analytics=\"title\" class=\"h4\">Thank You<\/h2>\n<\/p>\n<div class=\"cmp cmp-text aem-GridColumn aem-GridColumn--default--12\">\n<p>Thank you for contacting us. An Experian representative will be in touch with you soon.<\/p>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n<div class=\"modal fade form-renderer-modal\" tabindex=\"-1\" data-analytics=\"modal\" role=\"dialog\">\n<div class=\"modal-dialog\">\n<div class=\"modal-content text-center\">\n<div class=\"modal-body\">\n<div class=\"aem-Grid aem-Grid--12 aem-Grid--default--12 \">\n<figure class=\"figure\" data-analytics=\"image\">\n                        <i class=\"d-inline-block icon-comp magenta md exp-i-alert-pri-i\"> <span class=\"path1\"\/><span class=\"path2\"\/><\/i><br \/>\n                    <\/figure>\n<div class=\"cmp cmp-text aem-GridColumn aem-GridColumn--default--12\">\n<p>Oops! We were not able to submit your data. 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Key takeaways: Revenue cycle teams can use [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":7073708,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[234487,96697,166732,213255,213256,213254,108,130372,184185,99149,234488,234489,234490,234491,200113,200114,200115,234492,11896,184197,128099,234493,234494,234495,149517,200121,184204,184206,234496],"tags":[69544,11165,166743,213262,213263,2973,13085,12841,3346,234497,234498,234499,234500,234501,13033,157020,200131,200132,234502,24782,3254,128104,71588,3461,234503,234504,149529,200138,184222,184224,234505,8023],"dealstore":[],"offerexpiration":[],"class_list":["post-7073706","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-aa","category-ai","category-ai-advantage","category-ai-advantage-denial-triage","category-ai-advantage-predictive-denials","category-ai-insights","category-artificial-intelligence","category-automation","category-claims-contract-management","category-data-and-analytics","category-forrester","category-forrester-consulting","category-forrester-pac","category-forrester-study","category-klas","category-klas-first-look","category-klas-pac","category-klas-report","category-machine-learning","category-pac","category-patient-access-curator","category-predictive-analytics","category-revenue-cycle-analytics","category-revenue-cycle-automation","category-revenue-cycle-management","category-soc-2025","category-state-of-claims","category-state-of-claims-2025","category-total-economic-impact","tag-aa","tag-ai","tag-ai-advantage","tag-ai-advantage-denial-triage","tag-ai-advantage-predictive-denials","tag-artificial","tag-artificial-intelligence","tag-automation","tag-cycle","tag-data-and-analytics","tag-forrester","tag-forrester-consulting","tag-forrester-pac","tag-forrester-study","tag-intelligence","tag-klas","tag-klas-first-look","tag-klas-pac","tag-klas-report","tag-machine-learning","tag-pac","tag-patient-access-curator","tag-predictive-analytics","tag-revenue","tag-revenue-cycle-analytics","tag-revenue-cycle-automation","tag-revenue-cycle-management","tag-soc-2025","tag-state-of-claims","tag-state-of-claims-2025","tag-total-economic-impact","tag-ways"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Four ways to artificial intelligence and automation in your revenue cycle - Som2ny Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fivemor.com\/?p=7073706\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Four ways to artificial intelligence and automation in your revenue cycle - Som2ny Network\" \/>\n<meta property=\"og:description\" content=\"At A Glance Revenue cycle management automation and artificial intelligence (AI) can help healthcare organizations reduce manual work, catch errors earlier and prioritize claims that need attention. 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