Don’t write off revenue – automate it

Federal policy changes, labor pressures, and other industry trends are impacting health system margins more than ever, with McKinsey analysis showing that these factors could cut health systems’ margins by as much as 13 percentage points in the next five years. 

Yet many organizations continue to lose millions to administrative inefficiencies, denied claims, and delays in the revenue cycle. While manual processes may remain embedded in many health systems, leading organizations are shifting course and embracing automation across revenue cycle management to transform their bottom line.

The strategic case for revenue cycle automation

By automating high-volume, manual RCM tasks, health systems are reversing losses and reclaiming millions in revenue. Here’s what’s possible: 

Increasing speed to payment

One of the simplest ways to get payments quicker is to ensure that the payment process is smooth and available for patients 24/7. This can be done by automating workflows like: 

• Co-pay estimation and real-time eligibility collection: Automate the process of checking patient eligibility and estimating co-pays at scheduling, so patients know what they owe before their appointment and staff can collect at the right time. This reduces downstream collections work and improves payment rates. 
• Anytime payments: Allow patients to pay outstanding balances on their terms. Automated workflows for payments are always-on and span across digital channels, including SMS, web apps, and voice calls, to collect balances without relying on staff-initiated calls or mail. Patients can pay when and how they want, whether it’s 2:00 pm on a Tuesday or 11:00 pm on a Saturday. 

Montage Health increased its point-of-service cash collections rate by 2.8% by allowing patients to digitally pay co-pays and prior balances before arriving at their appointment and realized close to $2M in annual value from increased revenue capture and cost savings.

Reducing write-offs 

Automation of key workflows ensures both timely submission and accurate documentation, two key factors in avoiding denied claims and write-offs:

• HCC suspecting: Pre-visit HCC suspecting uses AI Agents to flag likely diagnoses before or during the admission process, prompting clinical teams to validate and document those diagnoses in real time. This reduces manual review by coding teams, increases compliance, and protects against denied or underpaid claims tied to incomplete documentation. 
• Notice of Admission (NOA) via fax automation: Submitting NOAs via fax is a painfully manual and error-prone process. Instead, AI Agents can automatically generate, fax, and verify NOAs, ensuring timely submissions and compliance with payer requirements. 

San Antonio Regional Hospital has gone 100% touchless with its NOA fax submission, saving hours of valuable staff time and accelerating reimbursement by streamlining revenue cycle workflows for faster, more accurate claims processing. 

Decreasing administrative costs

On average, organizations save $2.8M annually by automating manual RCM tasks. That’s not just in labor cost reduction; it includes avoided revenue loss, fewer re-submissions, and better payer compliance.

Montage Health’s estimated $2 million in annual gross value through revenue capture and cost savings has grown as new AI workflows have been deployed. Financial impact has come through reductions in no-shows, increasing point of service cash collections through digital co-pays and pre-payments, and reductions in cost to collect. 

MUSC Health has seen $5.5 million in annual value by deploying AI Agents across the enterprise, with a heavy emphasis on the revenue cycle and using automation to collect co-pays, avoid no-shows, and reallocate staff hours. 

The Future of Revenue Cycle is Automated

As denial rates rise and patient financial responsibility grows, health systems must adopt smarter ways to manage collections, recover revenue, and protect margins. 

Combining powerful AI with healthcare-specific workflows can empower health systems to stop writing off revenue and start reclaiming it. 

Ready to automate your revenue cycle and capture what you’re owed? Get in touch today.