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Dr. Michael Gao

👤 Speaker
345 total appearances

Appearances Over Time

Podcast Appearances

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

Yeah, absolutely.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

You know, I think to understand what Smarter does, one has to understand a little bit about what healthcare revenue cycle even is.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And I promise it's not going to be an arcane two-hour sort of pre-ramble on this.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

You know, fundamentally, what revenue cycle is, is that for hospitals to get paid for the care that they deliver—

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

They have to first take that care and generate a receipt for the care.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

So that's the process of forming the claim and understanding what the clinical care all corresponded to.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And then they have to jump through the 50 or so hoops for the payers to actually deliver payment for that care.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And so Smarter Technologies really is about solving both of those challenges with, you know, kind of AI and scale delivery.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And so the first component of that, which is really generating an accurate receipt for the care, is principally about clinical intelligence and being able to ingest care data and understand what that means.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And then, you know, use that to either

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

help facilitate documentation or understand if there's misses in the receipt.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And then the second is really the jumping through the 50 hoops process.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And that might be submitting things through a specific website, following specific rules and guidelines and things like that.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And so on that side, it's really about sort of the scale needed to understand those patterns

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

And then the automation needed to do that in a low-cost manner.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

So at the end of the day, it's just about helping hospitals make sure the receipt is correct and then decreasing the cost of collecting on the sort of payment for that care.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

Yeah, yeah, yeah.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

So

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

That's a really fascinating framework, actually.

Vanguards of Health Care by Bloomberg Intelligence
Smarter Technologies’ Blueprint for AI-Driven Revenue Cycle Management

So, you know, the reason why we have claims or, you know, if you've heard of ICD codes or CPT codes in the first place is kind of back in the paper chart days.

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