Artificial Intelligence’s First Application in Collections Yields Inspiring Outcomes
In what is the first commercial application of machine learning in outpatient rehab, Systems 4PT has harnessed Artificial Intelligence, (A.I.), to counter the bleak collection realities that define the current state of healthcare.
Systems 4PT integrates scheduling, EMR, billing and outcomes reporting in one, single database. Since 2013 we have been data mining, by payer, collection activity for our nationwide outpatient rehab customers.
The Problem That Affects All of Us:
Did you know that today, most practices billing software works exactly as it did 15 years ago? These systems are manual and highly dependent upon the biller’s input. Industry wide, these primitive billing companies encourage the thinking that, “Payer mistakes are a high-frequency fact of life”.
“The Industry” has it Wrong:
Payers are not adjudicating your claims with armies of sloppy employees, but with “super computers”. And their results are “super consistent”. Yes, payers do make mistakes. But payer errors are vastly outnumbered by errors resulting from manual, human-based claim creation in the practice: Incorrect / incomplete data, or failure to respond to changes in payer rules, (certainly aggravated by the fact that these rule changes are not properly communicated by the payer).
Changing the Paradigm to Improve Collection Outcomes:
The solution is to arm your practice with a “super computer” of your own. Systems 4PT’s technology continually monitors every claim, for every payer and every patient in your region. In this fluid process, machine learning establishes ever-evolving “Payer Norms”. Systems 4PT’s technology concurrently monitors every claim in your practice, looking for aging characteristics that violate these up-to-the-second payer norms. When outliers are identified, the computer tells the Account Manager to engage.
The computer tells the human, which claims to work, and when
It’s A LOT easier to correct a problem 15 days after signing the note, vs. 60 days. The fact that unpaid claims are corrected far before they are 30 days past due explains why Systems 4PT’s collection cycle (DSO) averages 18 days, nationwide. Our collection cycle is half of the 36-day DSOs advertised by the next-best billing software.
Leveraging artificial intelligence in the collection process has yielded inspiring results in an otherwise dismal payment landscape.
Systems 4PT practices’ average reimbursements per claim for Jan – June 2018
were even with Jan – June 2017 averages
This contrasts with our industry, which is peppered with headlines such as, “Continually Declining Reimbursements”, “Pessimism and the P.T.” and even the question, “Is Rehab on the Brink of Recession?”.
You’ve noticed the consolidation among billing software. Tired, outdated billing systems, acquired by EMR who lack the competence needed to program their own billing software. It’s obvious that acquiring and merging different C+ software companies do not make an A+ system. We refer to this as, “Dinosaurs mating”.
Payers are changing, morphing and improving
Payers are pounding your practice, with technology
Your practice is billing with the same approach you used back in 2008
That’s why your collections are declining
The Solution: Leapfrog the payers’ technology
There isn’t another option
Nationwide, Systems 4PT practices’ average collections per claim are higher today, than they were in 2013. No other billing software in outpatient rehab comes close to this level of collection performance. That’s because no other approach to billing software comes close to the technologies used today, by Systems 4PT.
Let’s fix it!