Overview
PMMC’s progressive Artificial Intelligence (AI) solution, RecoveryAI®, is an advanced AI solution that prioritizes accounts based on collectability, giving team members a clear starting point when contacting payers about outstanding bills. It generates an AI score that is comprised and trained on approximately 30 various components to determine collectability. A few of note include:
- The probability of collection
- The outstanding balance
- Denial reasons
- Procedure codes
The platform seamlessly combines AI and Machine Learning (ML) technologies. These features enable it to learn and evolve over time to leverage their organization and other organization’s historical data, like payment records, to determine which accounts will be the easiest to collect and generate the most immediate value for the organization.
RecoveryAI® has proved incredibly valuable to PMMC’s revenue cycle and collections teams looking for ways to streamline their management workflows. Let’s examine how one of PMMC’s recovery teams leveraged RecoveryAI® to reimagine and improve how it collected outstanding accounts.
The Challenge
Historically, the recovery team’s biggest hurdle was deciding which accounts to focus on first. The ability to accurately prioritize accounts was exacerbated during the pandemic, as collections teams received an increase in accounts to be collected. Additionally, the minor lag between services being provided and recovery teams getting involved in the revenue cycle made adjusting to these changes an even more daunting task. These events and challenges created a time management challenge for our team. Ready to optimize performance, the director of the recovery team saw a need for a more productive system to ensure that her team was managing their daily tasks efficiently and focusing their efforts on the right accounts. All of this set the stage for the development and testing of PMMC’s RecoveryAI® solution.
The Solution
PMMC was selected due to their solid track record in this area. Working closely with the hospital’s staff, PMMC has become an integral part of the organization’s team. RecoveryAI® represented the catalyst for overcoming the collections team’s time management deficits. Still, achieving optimized account processing efficiency also required buy-in from the team. The director of the recovery team kept her team in the loop from day one. In turn, the team grew to trust and embrace RecoveryAI®. With the help of RecoveryAI®, hospital management teams stayed ahead of the curve and provided the best possible care to their patients. As a result of their efforts, PMMC was able to thoroughly vet the AI platform before bringing it to market. Most importantly, PMMC’s recovery team demonstrated the efficacy of PMMC’s RecoveryAI® capabilities by adopting it themselves.
Once tested and refined, the RecoveryAI® algorithm significantly impacted the recovery team’s performance. After analyzing outstanding accounts, the platform assigns a tier to each account, which collections team members can quickly review to determine which account has the highest level of collectability. Since RecoveryAI® was fully implemented, the teams have streamlined their workflows. At the start of each shift, they can immediately get to work collecting the most promising accounts, which, ultimately, has led to more cash in the door for PMMC’s clients and higher client satisfaction as well. Prior to AI, collectors spent 65% of the time converting less collectable accounts to highly collectable accounts.
The Results
With RecoveryAI®, the PMMC recovery team reached an entirely new level of productivity for accounts to pursue. Instead, at a glance, the team can assess each account’s collectability and move forward to immediately generate revenue.
Implementing RecoveryAI® into PMMC’s workflow increased collectability by 85%. RecoveryAI® enabled the recovery department to settle accounts more efficiently because team members could submit more daily than before the platform’s implementation. At a base, PMMC’s contingency-based recovery results on average generates an additional 1-2% of net revenue. Going forward, PMMC’s recovery department will continue to make RecoveryAI® an integral part of its account prioritization process. The team will leverage its real-time insights to maximize collections efficiency. They will optimize total revenue while simultaneously providing a better experience for payers and clients.
PMMC’s platform prioritizes through scoring and automates the view of accounts to your AR staff. It automatically reduces the priority level on low-value or dead-end accounts so that your team stops wasting time on uncollectable variances. Instead, they can focus on pursuing valuable accounts and collecting revenue for your organization. The analytics capabilities of RecoveryAI® provide your management team with actionable insights that they can use to guide decision-making and further refine collection practices. By using these tools, they can gain valuable insights into various aspects of their operations, such as patient care, resource allocation, and financial management. The data collected and analyzed by these tools can also be used to guide decision-making and refining collection practices, leading to more efficient and effective healthcare delivery. PMMC invites your business to explore RecoveryAI® by scheduling a demo. RecoveryAI® and our suite of other solutions can help your organization modernize its revenue cycle and accounting process. Our team can also give you insight to our next steps for RecoveryAI®, like our automated appeals generator. With our support, you can stabilize cash flow and promote business continuity.
