Revenue Cycle Automation

Revenue Cycle Automation products use AI and elements of RPA to automate key workflows in revenue cycle management, including claims processing, prior authorization, patient payment collection, eligibility verification, and denials management. These platforms generally integrate with EHRs, practice management systems, and other RCM tools, and provide agents that can accomplish key workflows. Core capabilities include:

• Integration with existing systems through APIs or advanced web browsing capabilities

• Ability to define key workflows for automation, with well-defined inputs and outputs

• Tracking and analytics to understand effectiveness of workflow automations and identify key issues

While there are many RPA platforms, our focus with this category is on vendors who specialize in healthcare and RCM, or who have the scale to have deep expertise on healthcare workflows.