Reduce the burdens of claims, denials, authorizations, and more
Nearly every medical practice faces a common dilemma. Providers and staff want to devote as much of their time and energy as possible to delivering great healthcare, but economic realities force them, sooner or later, to pay close attention to Revenue Cycle Management.
That means devoting staff time to collections, identifying the best software for improving the efficiency of their financial operations, and training staff to make full use of those solutions. After all, the best care in the world won’t help patients if a practice cannot sustain itself financially.
It can be a lot to manage. And while artificial intelligence sounds like a great way to address RCM challenges, hesitation is understandable. Will AI really be an advance over manual systems? Will claims be submitted accurately? Will denials be properly managed? And will a practice’s investment in AI-powered technology see a return?
The short answers are yes, yes, and yes.
AI can reduce denials, lower costs, and increase revenue
Heather Boone is Clinical Supervisor at Orlando Heart & Vascular Institute, a privately owned practice with six providers.
By adopting eClinicalWorks AI for RCM, Boone said, her practice has been able to improve efficiency and lower its costs. While those are great outcomes on their own, they contribute to the practice’s larger goal of remaining independent while large hospitals in their area are absorbing many small, private practices.
“Our current AR net is under 30 days — at 21 days in fact — and then monthly our net has increased over 30% since bringing eClinicalWorks on board,” Boone told Healthcare IT Today during an interview at the eClinicalWorks and healow National Conference in Orlando this fall. “So, just that alone makes us stronger and more independent every day.”
A 2023 report in the International Journal of Scientific Advances found that:
35% of practices that implemented AI in their RCM operations realized cost savings of 10% or more
Claim denials were reduced by up to 50%
More than two-thirds (68%) of practices using AI saw improved RCM efficiency
“It all comes down to finances, being smart in where you spend your money,” Boone added. “But definitely, having the quick turnaround, getting your claims out and getting that money back in quicker — I think that’s where the eCW component allows that to happen.”
Blending the best of AI with human oversight
Studies and surveys across the healthcare industry today show that even with the remarkable growth of AI tools, only about 50% of practices are using AI in any form. Some are reluctant to embrace AI out of fear of the unknown or concerns about accuracy and safety. But for most, AI simply appears to add to the learning curve that staff must scale.
The good news is that eClinicalWorks is integrating AI into our products and services in ways that are both responsible and user-friendly. There are no courses to take. There are no technical manuals to read. And staff don’t need specialized degrees in computer science.
Using AI today is a matter of simply activating a given solution and working with a Strategic Account Manager or business development agent as needed to understand how to get started.
A survey of nearly 900 attendees at the 2025 eClinicalWorks and healow National Conference found that those contemplating AI for RCM anticipated realizing four key benefits:
An increase in revenue associated with the automation of appeals and claims
Reduced billing errors through more precise coding and eligibility determination
Faster payment cycles because of AI-drive billing inquiries
Continuous improvement in claim acceptance rates
None of those advantages, it should be noted, removes human oversight entirely from the RCM equation. While the AI for RCM solutions are tested and highly accurate, eClinicalWorks also equips practices with dashboards that give them the overviews and insights they need to be confident that their financial operations are in good order.
Both more and less complex over time
Interestingly, as Boone told Healthcare IT News, RCM operations are growing both more and less complex over time.
“It’s become less complex in the way of getting our claims out quicker,” she said. “We don’t have to rely on physical manpower so much anymore. The way the system is set up now, that AI bot is scrubbing and pushing out claims faster than our on-site staff can. But then we still employ people to scrub those claims.”
Ultimately, Boone said, the decision to choose eClinicalWorks AI for RCM was driven by the data. Orlando Heart & Vascular is a small practice with a small number of billers but blessed with a large patient population and correspondingly large influx of claims that need to be processed quickly.
“So, it just was a no-brainer that we wanted that revenue to come back to us quicker to prevent delays,” Boone said.
Finding errors quickly, preventing delays
Ultimately, of course, any RCM solution’s effectiveness is measured in time and money. How fast can it process claims and what financial return will it produce.
On both counts, Boone said, eClinicalWorks has shown real results for her practice.
“And that’s another thing with the RCM billing solution — what’s built into the system,” she said. “It finds errors and alerts you quickly, almost in real time to where you can complete them correct them so that claim goes out and prevents delays. For us as a small practice that’s a game changer. Since working with eClinicalWorks — we started in January — within three months we saw our monthly net increase over 30%. So that’s huge, that’s real dollars and cents. We had to recheck the numbers. Even our RCM billing lead was like ‘Yeah, you’ve really made leaps and bounds.”
To see how RCM services from eClinicalWorks can elevate your workflows, learn more below.
AI can reduce denials, lower costs, and increase revenue
AI can reduce denials, lower costs, and increase revenue
Both more and less complex over time
Finding errors quickly, preventing delays
