Articles

The Real Impact of AI on Revenue Cycle Management: What Healthcare Providers Need to Know

Oct 2, 2025

Given the benefits of artificial intelligence (AI) and automation in the workforce, it’s not surprising that today’s healthcare providers are increasingly adopting these technologies in healthcare revenue cycle management (RCM). In fact, about 46% of hospitals and health systems now use AI in healthcare revenue cycle operations, and the global AI in RCM market is projected to reach $70B by 2030. 

 

When implemented carefully and with ongoing oversight, AI in healthcare revenue cycle 

improves billing accuracy, reduces administrative costs, enhances patient engagement, and streamlines accounts receivable (AR) and denial management. The takeaway? AI and revenue cycle automation promote stronger financial performance. It isn’t a question of whether to make the leap into adoption—it’s a question of when. And experts agree there’s no time like the present to embrace AI in healthcare revenue cycle operations to improve healthcare finance efficiency.  

AI in Healthcare Revenue Cycle 

AI and revenue cycle automation don’t replace the RCM workforce. Instead, these technologies elevate it by performing repetitive, error-prone processes and allowing staff to focus on higher-value activities like resolving complex denials, negotiating contracts, and patient engagement. While robotic process automation can handle repetitive tasks like claim status checks, posting remittances, or pulling Explanation of Benefit data, AI in healthcare revenue cycle—or a mix of AI and automation in RCM—can perform these and many other RCM tasks: 

 

  • Appeals. AI can draft appeal letters and re-submit denied claims with minimal human intervention. 
  • Clinical documentation improvement. Algorithms flag missing or inconsistent documentation that could affect coding and reimbursement. 
  • Coding and billing. Algorithms analyze clinical documentation and assign accurate medical codes. 
  • Denial management. AI can identify claims that payers will likely deny and allows proactive resolution. 
  • Eligibility and benefits verification. AI can instantly verify insurance, detect coverage gaps, predict prior authorization needs, and estimate patient out-of-pocket costs.  
  • Payment variance and underpayment detection. Algorithms compare contracts vs. payments to identify when payers underpay. 
  • Self-pay AR management. Predictive tools prioritize high-risk accounts for collections. 

In the big picture, AI in healthcare revenue cycle management reduces manual errors, accelerates claim processing, and improves overall financial performance.  

Tangible Benefits of AI and Revenue Cycle Automation 

Organizations adopting AI and automation in RCM often see the following:  

  • Enhanced patient satisfaction. Automated reminders and up-front estimates inherent in patient engagement tools with AI capabilities keep patients informed and provide a smoother billing experience. 
  • Faster days in AR. Revenue cycle automation accelerates clean claim submission and payment posting, thus expediting the entire payer AR cycle. 
  • Improved net patient revenue. AI can help optimize collections and reduce revenue leakage. 
  • Lower cost-to-collect. AI reduces manual labor, thus lowering the resources needed for claim submission and follow-up.  
  • Reduced denials. Denial management technology with AI capabilities catches errors early so providers can correct claims prior to submission. 
  • Streamlined patient AR processes. AI-driven dashboards and predictive analytics highlight patient accounts that require attention and follow-up, thus improving cash flow and self-pay AR management. 

Here’s the bottom line: AI in healthcare revenue cycle management delivers tangible financial and operational benefits, ultimately boosting revenue while enhancing the patient financial experience. 

Real-World Applications of AI in Healthcare Revenue Cycle 

AI in healthcare is no longer a futuristic concept. Instead, it’s actively reshaping how healthcare organizations manage their revenue cycles. Following are several real-world examples of how hospitals and health systems are leveraging AI to improve financial performance. 

 

  • AR prioritization. Hospitals using AI to focus on the highest-yield or most at-risk claims first can improve cash flow and reduce days in AR. Many are also able to automatically route tasks to the right staff or auto-work low-dollar accounts, ensuring human expertise is directed toward complex, high-value claims. Early adopters report improved collection efficiency, reduced write-offs, and more predictable revenue performance. 
  • Coding accuracy and charge capture. Hospitals embedding AI into mid-revenue cycle workflows can accelerate coding, minimize rework, and improve case mix accuracy — ultimately reducing revenue leakage and enhancing compliance. 
  • Denial prediction and prevention. Hospitals piloting denial management technology with AI capabilities report fewer initial denials, faster reimbursement, and stronger cash flow. 
  • Eligibility verification and pre-authorization. By streamlining time-consuming, manual front-end processes, hospitals can cut administrative delays, decrease claim denials linked to missing approvals, and accelerate patient access to care. 
  • Healthcare finance efficiency and workflow automation. Reducing manual workload allows hospitals to promote faster turnaround times, fewer errors, lower administrative costs, and improved staff satisfaction. 
  • Patient engagement and collections. When hospitals use patient engagement tools with AI capabilities to make the self-pay AR management process more personalized, transparent, and proactive, they can align financial interactions with patient preferences, increase collection rates, and improve patient satisfaction and trust in the billing experience. 

As the use cases for AI in healthcare revenue cycle management continue to expand, these and similar stories will continue to make headlines and pique interest in the technology as a viable strategy to improve financial performance. 

 

Implementing AI and Automation in RCM 

To implement AI and automation in RCM, organizations must take the following steps: 

 

  1. Engage external experts. In the absence of internal expertise, partner with vendors or consultants to ensure smooth integration and effective return on investment. 
  2. Evaluate current processes. Identify high-impact areas like billing, denial management, and AR follow-up that can benefit from AI and revenue cycle automation. 
  3. Monitor key performance indicators. With the rollout of AI and revenue cycle automation, track denial rates, AR days, collection rates, and payment plan adherence. Then refine AI in healthcare revenue cycle strategies accordingly to improve billing accuracy AI.  
  4. Obtain staff buy-in. Train staff on how AI complements workflows and reduces errors and administrative burden; however, remain open to feedback on how to improve performance and billing accuracy AI. 
  5. Select the right tools. Implement AI and revenue cycle automation solutions that are compatible with existing EHR and billing systems, so minimal integration work is required. 

Following these steps helps ensure organizations maximize the effectiveness of AI and automation in RCM.  

Best Practices for Maximizing Impact 

In addition to following the steps listed above, organizations derive even greater value from their technology investments when they: 

  • Combine AI in healthcare revenue cycle insights with human judgment.  
  • Continuously review denial patterns and AR trends to look for potential vulnerabilities and gaps with billing accuracy AI tools. 
  • Prioritize change management when deploying AI in healthcare revenue cycle operations. 

 

Remember: AI doesn’t replace humans. It elevates them and their roles. AI is not exempt from making mistakes which is why AI and humans must collaborate. 

 

As AI and automation continue to redefine healthcare RCM, providers that strategically integrate these technologies into their operations can reduce costs, improve self-pay AR management, and enhance the patient financial experience. AI in healthcare revenue cycle operations is a tool to optimize performance and prepare for the evolving healthcare landscape. Embracing AI helps providers deliver measurable improvements in billing accuracy, healthcare finance efficiency, denial reduction, and patient engagement.  

 

 

Karie Bostwick

VP of People and Compliance

As VP of People and Compliance at Revenue Enterprises, Karie Bostwick oversees People functions including recruiting, training, onboarding, engagement and satisfaction. Additionally, she is responsible for compliance training, oversight and monitoring.

Karie has a long history of working in the revenue cycle support industry. Her skills span leadership, operations start up, policies and procedures development, operations workflow, budgeting and client management.

She is passionate about the experience of our people, patients and the Healthcare clients we serve and believes that a team of diverse, talented and motivated individuals working together toward a common goal can make a difference.

Robert Sterett

VP of Information Technology

As a transformational leader Robert Sterett has leveraged his 20 years of experience to build effective service lines and exceptional teams. In his role as VP of Information Technology at Revenue Enterprises, Robert excels at taking a unique, balanced, and strategic approach to technology leadership with people first for the best possible outcome. Using his experience from engineering, project management and service line management he takes a multi-faceted approach to ensure the right people are in the correct position coupled with the best technology to meet or exceed all expectations from security to compliance and business continuity.

Robert’s leadership style lends itself to building long term relationships and has consistently been a relied upon strength in many organizations. Over Robert’s time as an IT operational and project leader, he has spent significant time in both hands-on technology facing roles and client centric management roles to bring the best solutions that strive to meet the business and client needs.

Focusing heavily on his personal development skills and opportunities, Robert continues to foster coaching and mentorship relationships everywhere in his life, and the lives around him.

Douglas Dunbar

VP of Sales & Marketing

As VP of Sales and Marketing for Revenue Enterprises, Douglas Dunbar leads with a passion for building strategic partnerships, nurturing relationships, and upholding customer service excellence. In his role, Doug focuses on marketing and brand strategy, sales team leadership, and working closely with members of the management team to best serve company goals.

Doug has over 28 years of National sales and marketing call/contact center leadership, with 10 years of service specifically at Revenue Enterprises. Currently, Doug serves as part of Wyoming HFMA Chapter leadership and has held various roles in Colorado HFMA Chapter leadership for over 9 years.

In his spare time, Doug is very family oriented. Additionally, he loves traveling, cycling, golfing, fishing, hunting, and boating.

Kris Brumley, MBA

President & COO

As President & COO of Revenue Enterprises, Kris Brumley is a collaborative partner within the executive team and a leader for operational functions across the organization. Kris productively shares vision, drives innovation, and supports those around her in a way that elevates them and fosters continuous improvement and results. She has helped create a supportive environment for clients resulting in 98% client retention and a 65% NPS score for all clients and 75% for top clients by revenue.

Kris possesses an MBA in data analytics and has twenty-five years of experience in the healthcare industry, with 19 specifically in revenue cycle. She brings a wealth of customer service experience to her role and has worn many hats at Revenue Enterprises including Director of Business Development, EBO Division Director, and VP of Client Experience Management.

In her personal life, Kris is as busy outside of work as inside. She values spending time with her family, and enjoys fishing, hiking, traveling and interior decorating and design.

Timothy (Tim) Brainerd

CEO

As CEO of Revenue Enterprises for almost 20 years, Tim Brainerd leads by example. He promotes a shared vision and stewards a culture of Integrity, Passion, and Respect. He has assembled and empowered high-performing talent and teams to support customers, facilitate strategic planning and manage the capital of the company. Under his leadership, Revenue Enterprises has doubled in size three times over the past fifteen years while maintaining a culture of caring and gratefulness.

Tim has close to four decades of revenue cycle experience, including nineteen years with RSI
Enterprises. He has been a past president of Colorado Chapter of the HFMA and a presenting speaker on the topic of Leadership. He is a fifteen-year member of Vistage International, the world’s largest CEO coaching and peer advisory organization for small and midsize business leaders.

Raised in the Midwest, Tim values humble principles like being respectful, caring, passionate, self-reliant, and most importantly grateful. His most important lesson and the lesson he hopes to pass on in all relationships is living the Golden Rule–do unto others as you would have them do unto you. He is intentional in his choices and believes in making decisions, taking action, being accountable, and loving your neighbors.

Whenever possible, Tim spends his time with his wife of nearly forty years, his adult children, and his grandchildren. His hobbies include fishing, golfing, traveling as well as game nights and sharing great food with his family.