Rajeev Ronanki’s Post

📉 Impact ⤵ The evolving landscape of payment integrity demands that health plans adopt advanced prepay claims editing practices. By integrating #AI and staying agile with #regulatoryupdates, #healthplans can improve #administrativecosts, member satisfaction, and provider relationships, positioning themselves as leaders in the healthcare ecosystem. 💡 Insight ⤵ Effective prepay editing goes beyond cost savings—it enhances transparency, fosters trust with providers, and streamlines operations. Health plans that leverage AI and evidence-based policies will not only improve claim accuracy but also reduce post-payment issues and enhance overall efficiency. ❓ Questions to Think About ⤵ How can health plans balance cost savings with maintaining strong provider relationships? What role will AI play in the future of prepay claims editing? How can transparent claim adjudication improve member satisfaction and trust? #HealthcareInnovation #PaymentIntegrity #PrepayEditing #AIinHealthcare #ClaimsManagement #HealthPlans #ProviderRelations #OperationalEfficiency

Managing the traditional #referralprocess comes with numerous challenges for referring doctors—time-consuming tasks, heavy administrative burdens, and the potential for errors that can impact patient care. AI-driven solutions like FYRA are transforming this process, enabling doctors to focus more on their patients and less on the complexities of referrals. Here’s how FYRA is making a difference for referring doctors: ✅Time Savings: FYRA automates data collection, scheduling, and other time-intensive tasks, freeing up doctors to spend more time on patient care. ✅Reduced Administrative Burden: By managing processes such as insurance verification, eligibility checks, and documentation, FYRA significantly lightens the administrative load on healthcare practices. ✅Improved Accuracy: FYRA’s AI-driven processes enhance the accuracy of referrals, ensuring that patients are matched with the right specialists quickly and without errors. ✅Clear Referral Guidelines: FYRA provides doctors with clear instructions on what information to include in referrals, reducing the risk of missing or incomplete data. ✅Easier and Transparent Communication: With FYRA, communication between referring doctors and specialists is simplified and transparent, making it easier to track the referral status and ensure accountability at every step. ✅Tracking and Accountability: FYRA’s platform offers real-time tracking of referrals, allowing doctors to monitor the progress and outcomes, ensuring patients receive the care they need in a timely manner. Ready to transform your referral process? Contact us today to schedule a product demo and see firsthand how FYRA can revolutionize the way you manage referrals. Reach out to us at [email protected] #HealthcareInnovation #AI #MedicalReferrals #ReferringDoctors #HealthcareAutomation #FYRASoftware

Need to lower the cost of recovering denied claims? AI is already helping 1,300+ WhiteSpace Health clients do just that. Learn how in today's blog, penned by our VP of marketing, Carrie Bauman. https://hubs.la/Q02XnhZc0 #RCMAnalytics #HealthcareAI #DenialRecoveryAI

Need to lower the cost of recovering denied claims? AI is already helping 1,300+ WhiteSpace Health clients do just that. Learn how in today's blog, penned by our VP of marketing, Carrie Bauman. https://hubs.la/Q02XncBh0 #RCMAnalytics #HealthcareAI #DenialRecoveryAI

Attention Healthcare Administrators .. You don’t need to worry about Too much paperwork Endless Coding errors, insurance rejections , delayed payments as these Problems are killing your Time , money, Slowing down Patient cares.. Instead you an Use an Ai Powered System that reads Doctor notes , Patient records, learn from Past data , send bills, check payments and can even Predict errors. If you want to know exactly how you can implement this AI 🤖 in your System Connect with me and I will show you exactly. #SyedAI #Healthcareadministration #AI #Hospitals

SPOILER ALERT...it's DENIALS, but was there ever really a question?! Experian's 2024 State of Claims report outlines in a recent survey completed that payer policy changes are happening more frequently and both time to reimbursement and errors in claims are increasing year over year. So then what's the solution? How about instead of throwing people and money at the problem, we deploy cost effective and scalable technology that leverages AI to automate this work and reduce errors! Here at Athelas, AI technology is helping our partners achieve record low denial rates by digitizing both site-specific and industry logic to track policy changes and catch claim errors up front to reduce as much of the manual headache as possible. Sound too good to be true? To me, seeing is believing, let's talk! #HealthcareAI #AIAutomation #DenialManagement #HealthcareDenials #Experian2024StateofClaims #DamnDenials #AutomateRCM #AIBilling

Good stat: Experian Health data shows 51% of #healthcare providers currently leverage some software automation. Not-so-good stat: Only 11% have integrated AI technology into their organization. Adopting Claims technology can be a 'gateway' tech platform to embrace artificial intelligence and enter the present (AI is not the future - it'a already here). If you're a blog reader, you're in luck - we're talking (or typing) about it over at experian.com/healthcare. Join the conversation.

EVA has your back for all things Eligibility! Establishing high patient data integrity at the start of the patient journey leads to a positive downstream impact on prior authorization, claims processing, and payment posting. Learn more about what EVA has to offer 👇

Get Ready for 2025: Boost Your Practice’s Revenue and Reach with AI-Enhanced Credentialing! With the new year approaching, now is the ideal time to expand your insurance network and open your practice to more patients. Credentialing doesn’t have to be a burden—especially when you combine the expertise of credentialing specialists with the power of AI. In our latest article, we cover: ✅ How AI-powered credentialing tools save time and money ✅ Why credentialing with more insurers before 2025 can boost your revenue ✅ Practical steps to prepare your practice for the new year Make 2025 a year of growth with faster, more efficient credentialing that minimizes errors and maximizes patient access. Dive into the article to learn how AI is transforming credentialing and how it can benefit your practice! 👉 https://lnkd.in/e4B--tnX #Credentialing #RevenueCycleManagement #MedicalBilling #AIinHealthcare #PracticeManagement #Healthcare

AI is going to transform the payment integrity industry allowing payers and vendors to profitably target lower and lower dollar overpayments. However, this is a good reminder that human decisions and quality controls are still just as important.