Artificial intelligence plays a pivotal role in streamlining various business processes, from managing customer service queries through chatbots to compiling data for analytics. This technology, known as AI, is designed to handle tasks that would typically require human intelligence, thereby reducing the need for manual intervention.


Artificial intelligence in revenue cycle management works by simply running a computer platform or application to take on the processes that would’ve previously been done manually. Additionally, with the use of algorithms, an AI-enhanced RCM platform has learning capabilities, which means over time, it will function even more comprehensively than it did to start. Ultimately, AI has made it possible for businesses to rely less on human labor for these tedious, repetitive tasks that require a high level of detail. Instead of relying on the workforce to handle these boring tasks, healthcare businesses can use AI-powered RCM platforms to operate more efficiently.

Industries That Use Revenue Cycle Management

When considering efficiencies, AI in revenue cycle management is one option that tops the list for medical practices, in fact its use is becoming more common in facilities all over the country. Using AI allows businesses to run more efficiently both in operations costs and in time because it frees up their existing staff to tackle more complex processes instead of being tasked with tedious, monotonous, and often boring jobs. Let’s dive in and look at how AI can improve revenue cycle management.


While we are primarily going to address how artificial intelligence is used in revenue cycle management in the healthcare industry, other industries with complex billing processes, such as the hospitality industry or any industry that deals with getting reimbursement from insurance companies.

What Can AI Do For Revenue Cycle Management?

In the healthcare industry, revenue cycle management includes the many processes that are required for a medical practitioner, clinic, hospital, or facility to capture revenue. The revenue cycle includes everything from medical billing and coding to filing claims with insurance companies, receiving payments from patients and reimbursements from insurance, and third-party follow-ups. 


Even just thinking about the most basic functions of the healthcare revenue cycle, it’s obvious that it is a very complicated and time-consuming process. Utilizing AI in revenue cycle management could be a game-changer for capturing funds because it streamlines the administrative processes and eliminates time-consuming tasks.

Benefits Of Using AI In Revenue Cycle Management

Integrating AI into revenue cycle management can yield significant benefits for hospitals and healthcare facilities. This includes alleviating staffing challenges, enhancing operational efficiency, providing valuable predictive analytics, ensuring fraud protection, and bolstering revenue integrity. 

Increased Efficiency

Following up on claims, insurance verification, and confirming the correct medical codes are used for billing are all very time-consuming processes. By streamlining these processes with AI in revenue cycle management, time-consuming tasks are done accurately and more quickly. This also helps out other related processes, such as investigating denied claims and handling appeals. The entire revenue cycle benefits from AI.

Predictive Analytics

Using AI in revenue cycle management also paves the way for predictive analytics to be used. Predictive analytics can be part of AI in revenue cycle management because it can create opportunities for a bot to handle insurance requests for more information. It can also auto-generate information, such as appeals based on specific codes, to help automate and streamline processes. 

Fraud Detection

Fraud detection is another way that artificial intelligence in revenue cycle management can be used. By incorporating high-level security systems that are in compliance with the stringent medical requirements, hospitals and healthcare organizations can safeguard themselves from fraud, whether it’s identity theft or fraudulent claims. Unfortunately, when these tasks are outsourced instead of automated, there are more opportunities for fraudulent activities to occur.

Enhanced Revenue Integrity

Artificial intelligence in revenue cycle management can also provide enhanced revenue integrity because there are fewer errors, which means the correct services are billed under the correct code. Additionally, revenue cycle intelligence can run analytics to detect anomalies or issues that should be examined and potentially corrected. 

Platforms That Use Artificial Intelligence In Revenue Cycle Management Technology

Artificial intelligence is already becoming prolific in revenue cycle management, and there are a number of platforms that are embracing this technology. Currently, the best technology platforms in RCM are using some form of artificial intelligence, and this has been for quite some time. Many have recently begun expanding their use of artificial intelligence in revenue cycle management.


As AI in revenue cycle management continues to expand, more systems and platforms will begin to incorporate this technology because of the benefits it provides. No matter which system you prefer to use, AI in revenue cycle management is likely here to stay.

Epic Systems

Epic Systems, one of the most popular medical software around and home to MyChart utilizes artificial intelligence in its programming. Announced in May of 2023, Epic proclaimed they were first going all-in on generative artificial intelligence at UNC Health. Our team at Credence Global Solutions is experienced in using Epic Systems and can easily help transform your business.


Cerner is also a common choice for healthcare providers as an RCM platform. Similarly to Epic Systems, Cerner announced in September 2023 that they were adding generative AI to their platform. Cernis is another platform of choice at Credence Global Solutions.


Athenahealth has been incorporating machine learning for the past decade. The healthcare giant noted in December of 2023 that it would be expanding AI use in its platform. Our team is well-versed in all aspects of Athenahealth’s platform and would be excited to help your business implement this transformative technology.

Who To Contact For Implementation Of Revenue Cycle Technology

If your healthcare facility is at a point at which you need help with billing, it’s likely time to call in the experts. Our talented team of RCM experts can help you properly capture revenue, identify opportunities to streamline processes, and more.


Are you ready to implement artificial intelligence in the revenue cycle management of your healthcare facility or practice? We can help get your preferred platform set up and your RCM in place. Contact us today to learn more!