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Conversational AI Can Help RCM Providers in Early-Out Collections and Here’s How

Early-out collections are a critical phase in which revenue cycle management providers aim to recover outstanding payments from patients within the initial 90-120 days post-bill creation. However, despite its significance, the early-out collection process presents challenges that can hinder the collection efforts and, ultimately, the RCM providers’ cash flow. 

In this article, we will explore how multichannel AI solutions can bridge the gaps, expedite collections for RCM providers, and improve the patient experience.

Too Little, Too Late: Why It’s Difficult To Execute a Timely Early-Out Campaign

The phase of early-out collections is crucial. Revenue cycle management (RCM) providers must collect outstanding debts from patients within 90-120 days. This is necessary to swiftly close dues and maintain a stable revenue stream. 

The challenge?

RCM providers face immense pressure to resolve outstanding self-pay dues, knowing that delays can have significant consequences. After the 90-day mark, unresolved self-pay dues may escalate to accounts being written off and passed to third-party collection agencies or legal firms, worsening the strain on an already fragile margin in a challenging market.

However, amidst the flurry of calls and the limited timeframe, RCM agents often struggle to connect with patients holding self-pay dues, managing only a few attempts below the optimal frequency needed for successful collections. RCM providers typically do not have enough agents to handle patient outreach at the scale required to execute an effective early-out campaign.

This issue is compounded by the perpetual rise in agent attrition, which not only hampers smooth operations and continuity, but also escalates the cost of recruitment and training, further squeezing RCM providers’ profit margins. 

Let’s have a look at the challenges in detail:

Inadequate Number of Follow-Ups

Revenue cycle management providers struggle to effectively engage patients despite most of the accounts being very recent, primarily due to limited scalability. This results in missed opportunities to resolve patient dues, ultimately leading to revenue losses.

Complex Bill Disputes

Patients frequently raise inquiries regarding their bills, requiring time-consuming interactions to address their queries and alleviate concerns. This intricate process demands significant time and resources from RCM providers to ensure accurate explanations and satisfactory patient resolutions. Addressing these queries is essential for maintaining transparency and trust in the healthcare providers.

Thin Margins

With the rise in popularity of high-deductible health plans (HDHP), many patients are left with significant self-pay dues. When patients are unable to complete their self-payments, healthcare providers are forced to write off these dues and a large share of their revenue, therefore affecting profit margins.

Staffing

Most sectors are undergoing struggles related to staffing, caused also by high inflation rates. Revenue Cycle Management (RCM) providers are no different. Hiring channelges are worsened by increasing attrition rates and the expenses tied to hiring and training. This directly affects the efficiency of managing early-out collections and incoming patient inquiries, impacting profits and patient satisfaction.

Can Multichannel Conversational AI Help in Early-Out Collections?

The answer is yes.

But what exactly is Multichannel Conversational AI?  In simple terms, it’s a technology that leverages multiple channels like email, SMS, phone calls (Voice AI), and web chat to handlehuman-like, two-way conversations with consumers.

Multichannel AI offers a promising avenue to address the pain points in early-out collections and optimize revenue recovery efforts. 

Here’s precisely how Skit.ai’s Multichannel Conversational AI solution can help in early-out collections:

Scalable Automated Patient Outreach

Skit.ai’s AI bot can initiate personalized outreach to patients via multiple channels, such as phone calls (Voice AI), text messages, emails, and chatbots, ensuring effective communication and engagement from the outset. This ensures swift connection and meaningful engagement with patients and, at the same time, offers scalability to RCM providers to reach out to numerous patients in bulk.

Handle Payments and Inbound Queries

Skit.ai’s AI bot can authenticate patients, clarify bill breakdowns, answer patient queries, facilitate on-call payments and text-based payment links, and even set up payment plans, enhancing convenience and reducing barriers to receiving payment.

Improved Efficiency and Reduced Agent Costs

Skit.ai’s AI bot augments human efforts by automating repetitive and time-consuming tasks, enabling RCM staff to focus on resolving complex disputes and providing personalized patient assistance. This includes clarifying bills, patient follow-ups, payment assistance, and post-call activities.

How Will RCMs Benefit from Skit.ai’s Multichannel Conversational AI?

Now that we have explained in brief how Skit.ai’s multichannel conversational AI solution can help RCM providers expedite early-out collections, let’s look at how RCM providers can benefit from the adoption of this technology: 

Increased Cash Flow: Extensive outreach through multiple channels boosts patient engagement, leading to higher payment rates. 

Shortened Recovery Cycle: Targeted outbound campaigns powered by AI accelerate the collection process, improving cash flow. 

Reduced Charge-Offs: By minimizing the number of bills sent to collections, AI helps mitigate bad debt losses.

Solved Staffing Challenges: AI augments human resources, enabling RCM teams to handle larger volumes of accounts efficiently.

Cost Savings: Automation reduces operational expenses and maximizes revenue recovery, contributing to overall financial health.

The Effects on Patient Experience and Compliance Concerns

For healthcare providers,the patient experience is of utmost importance. From reaching out to patients regarding their self-pay dues to collecting payments, your technology partners must ensure that patients have a top-notch experience, and the same applies when they interact with Skit.ai’s virtual assistants.

With Skit.ai, RCM providers elevate patient experience by:

24/7 Inbound Support: Skit.ai’s bots can quickly clarify bill details, alleviating confusion and building trust among patients. Patient queries are promptly addressed whenever they reach out, be it on weekends or after work hours.

Multiple Channels: Patients expect and appreciate the flexibility to communicate through various channels according to their preferences. Skit.ai provides multiple communication channels that enhance engagement and cater to diverse consumer needs and preferences, fostering a positive customer experience.

Convenience: Seamless payment options (on-call and link-based payments) and quick responses to payment queries improve satisfaction and reduce friction in the billing process. Our bots can also negotiate payment plans and set up payment plans for ease of collection.

In addition to delivering exceptional patient experiences, we recognize the significance of compliance for RCM providers, particularly in handling patient information. That is why we are proud to comply with all federal and state regulations, including HIPAA, the TCPA,TCPA, HIPAA, and more; additionally, Skit.ai has data security certifications such as PCI-DSS, SOC 2 Type II, and ISO 27001:2022 

Conclusion

Integrating multichannel Conversational AI solutions into early-out collections processes offers a transformative approach for RCM providers. Conversational AI empowers RCM providers to navigate challenges effectively and achieve sustainable financial outcomes in a rapidly evolving healthcare landscape by addressing pain points, enhancing efficiency, and improving patient satisfaction.

Automate Early-Out RCM Collections with Conversational AI

The complex world of healthcare revenue cycle management (RCM) and patient billing is evolving rapidly. New digital tools are enabling providers to tackle early-out collections, prevent charge-offs, and improve recovery strategies. For healthcare organizations’ patient billing and RCM providers, early-out collections are a crucial piece of the patient billing puzzle, and AI is here to help.

By contacting patients early and kindly after sending a bill, early-out practices encourage patients to make a payment before the bill is charged off and handed over to collections. This practice can significantly improve an organization’s cash flow as well as the customer experience. However, RCM businesses and divisions often lack the necessary resources to consistently implement early-out collections on a widespread scale.

In this article, we’ll explore how Conversational AI technology can streamline the revenue cycle management (RCM) process. This technology can significantly reduce the revenue cycle duration by automating two-way, human-like conversations with patients, engaging them effectively, and sending reminders through a multichannel approach. Ultimately, these advancements aim to enhance profit margins for healthcare providers.

Early-Out Collections for Healthcare RCM and Billing: Common Challenges and Pain Points

Early-out collection practices help prevent bad debt, encouraging patients to pay their bills in a timely manner. From the provider’s perspective, early-out practices help improve cash flow through revenue recovery.

However, that’s easier said than done. Here are some of the most common challenges and pain points faced by healthcare RCM and patient billing providers:

Patient outreach and follow-ups: The recentness of the bills presents an opportunity for collectors since the consumer is usually easier to reach. But to accomplish the goal, patients must be contacted timely and regular follow-ups must be conducted. The need for multiple engagements and touchpoints can represent a challenge when your business doesn’t have enough staff to handle all these calls manually.

Agent staffing: Agent bandwidth and staffing present a serious challenge for RCM providers. In the last few years, hiring and retaining staff has become very expensive for businesses, with attrition and training costs adding to the strain.

Thin profit margins: Due to low payments and high expenses, RCM businesses are seeing their profit margins shrink. Additionally, due to the rise of High Deductible Healthcare Plans, the average balance of self-pay accounts is higher, making it more difficult for patients to complete their minimum deductible payments.

Debt breakdowns and complex disputes: Patients may inquire into bill breakdowns and insurance intricacies. RCM agents are required to provide the bill breakdown, adding an extra layer of complexity to the recovery cycle.

Long recovery cycles: When it comes to healthcare bills, the clock ticks due to stringent deadlines. Failure to meet these deadlines will cause the bills to go delinquent. If insurance billing is not closed within 90 days of bill generation, insurers can reject any claims against the accounts later, impacting the healthcare provider. When the bill goes to collections, the involvement of third-party collection agencies will reduce the RCM provider’s margins. Additionally, if too many bills are charged off, the healthcare provider will likely stop working with the RCM provider.

What Is Multichannel Conversational AI for Patient Billing Collections

RCM providers are no strangers to software that can simplify and automate many day-to-day tasks. Conversational AI powered by large language models can transform early-out patient billing collections by automating patient outreach through multiple channels, such as phone calls, text messages, emails, and chatbots.

Outbound collections with intelligent bots enable RCM providers to reach as many patients as needed, engage them in human-like conversations, and encourage them to make a payment. This approach allows for effective patient outreach while optimizing the collection process and generating cash flow. Here’s what a bot can do:

  1. Initiate a call or send a text message to engage the patient.
  2. Authenticate the patient by verifying their identity.
  3. Provide bill breakdown and answer questions.
  4. Collect payments on-call or direct patients to a payment portal.
  5. Set up payment plans when needed, especially for high-amount bills.
  6. Transfer the call to a live agent when requested.

Skit.ai’s solution is compliant with all federal and state regulations, including the following laws: TCPA, HIPAA, and more.

The Benefits of AI in Early-Out Collections

Collect more payments: With Conversational AI, you can automate and schedule patient outreach at the right time and using multiple channels (e.g., phone and text messaging). This extensive outreach will generate more engagement and connectivity, driving more timely payments to your business.

Shorten the recovery cycle: Targeted outbound campaigns powered by AI will shorten the average recovery cycle, boosting cash flow.

Reduce charge-offs: Early-out collections enable you to reduce the number of charge-offs, i.e., bills that go into collections and become bad debt. Avoiding charge-offs will help you avoid additional headaches.

Solve staffing challenges: AI is not here to substitute humans but to augment their work. By adding AI to your current team, you’ll help them focus on disputes and complex cases and enable them to service a larger number of bills.

Save $$$: Leveraging artificial intelligence and automation can significantly drive down expenses and help you promote a healthy flow of payments.


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