Pioneering Unified Automation™ For Healthcare Revenue Cycle Management

Author: Alpha Health

At Alpha Health, we believe that every dollar spent on healthcare matters, because healthcare matters to everyone. Complexity in medical reimbursement in the United States drives up hidden costs that we all pay; both in terms of dollars, and, in the erosion of trust people have that our healthcare system will serve them well.

Although unknown to the vast majority of Americans, the leader of the revenue cycle department at a hospital or clinic is responsible for managing the financial infrastructure of healthcare. Their role is central, their decisions and actions influence millions of providers and patients, and billions of dollars. Yet, they are some of the most underappreciated and underserved executives in healthcare.

Every revenue cycle leader we’ve ever spoken to is on a mission to be a better steward of the healthcare dollar. They recognize the ever-increasing demands on their team brought on by an increasingly complex reimbursement environment. When complexity can’t be addressed by simply adding more staff, leaders often explore new technologies to bring efficiencies at scale.

Unfortunately, the technology industry has not stepped up to help revenue cycle leaders meet their ambitious goals. Modern machine learning technology is often focused on clinical applications within healthcare, and little thought is given to applying those same approaches to the back office. Most current automation efforts are driven by repurposed technology like robotic process automation (RPA) that are actually decades-old. As a result, revenue cycle leaders are stuck stitching together multiple pieces of archaic technology. The end result is often more hassles than help from a patchwork of cumbersome technologies.

At Alpha Health, we’ve developed a new approach we call Unified Automation — a single solution to automate and simplify revenue cycle management. We evaluated modern automation approaches from some of the most complex domains in the world (such as self-driving cars), and we derived core principles — like the best ways to monitor existing workflows, learn from workflows at scale and quickly adapt to change. We then built proprietary technology from the ground up to apply these core principles to the unique challenges of healthcare revenue cycle management.

We were very thoughtful about designing each component of our solution to fit together perfectly. We don’t white label software from other vendors. As a result, our vertically integrated solution includes every single component required for revenue cycle leaders to roll out the most comprehensive and advanced automation solution available, eliminating the need for a cumbersome patchwork of solutions.

Our solution lives and operates within the existing electronic health record (EHR) and billing systems of our clients. We can deploy entirely remotely and there is no new training required for existing health system staff.

Here’s how Unified Automation works:

How unified automation works diagram

    • First, we observe existing workflows. We start by deploying our proprietary software that captures multi-modal data sets to provide a 360-degree view of current workflows and processes.
    • Next, our system learns your workflows. Our machine learning algorithms are trained using this data and then autonomously constructs complex flows that are impossible to script by hand. They also correct broken workflows and often eliminate unnecessary work.
    • Finally, the system starts automating tasks and taking on new tasks as it learns over time. It performs just as your staff do. If complexities arise, such as changes to payer protocols, the system immediately flags our TeleOps team of revenue cycle experts who triage the problem and resolve it in real-time, while our system learns the new process. Your RCM operations continue uninterrupted. Continuous learning is built in, providing peace of mind.

    Unified Automation is a unique approach because it seamlessly blends human judgement and subject matter expertise with machine learning. Unified Automation is also antifragile. This means it extends beyond simple resilience or robustness. Resilient systems resist variance and disorder and stay the same; an antifragile system thrives and improves as a result of that same variance and disorder.

    Alpha Health’s Unified Automation is driving unparalleled performance for RCM teams today. Our solution operates within the existing electronic health record (EHR) and billing systems of our clients. Our deployments can be done entirely remotely. Our AI can be up and running within 90 days of receiving data — providing real results rapidly. As our solution learns and takes on more tasks, health systems can reallocate staff to more meaningful work. Below is a look at results from a customer where we scaled up quickly, and within three months, provided value equivalent to more than 8 full-time employees.

    Full-time employees bar graph

    Unified Automation offers revenue cycle leaders at health systems and providers of all sizes a powerful new tool for doing more with less. Unified Automation can help restore trust in healthcare, by bringing together the best of people, data and technology to address financial complexity in the US healthcare system.

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