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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

And so actually on the SmarterDx pre-bill product, we identify downgrades as well as upgrades when the underlying care isn't justified.

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

And hospitals actually like that because...

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

What's not great is when you don't get paid for, you know, $10 that you thought you would get paid.

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

What's much worse is if you first spend 60 days arguing about it and then you realize you're in the wrong and then you don't get paid the $10 anyway.

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

And so I think there's, you know, kind of, I think what I kind of hope is that the arc is that as we get more and more accurate about the connection between the underlying care and what's on the claim, that we can start convincing payers to say, hey, look, this is a claim we have extremely high confidence in.

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

Here's all the evidence connected to every single claim, for lack of better words, on that claim.

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

And I actually hope that over time that reduces the friction as well.

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

So, you know, I think we work across a broad range of sort of contracting.

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

So we have contingency, we have more traditional SaaS models, and then we have, you know, some of our tech-enabled services work is more sort of on a per-transaction basis.

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

The key here is obviously you want to

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

You wouldn't want to have a purely an FTE-based business model, and then you automate away the FTEs and, you know, kind of your revenue decreases.

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

And transaction-based allows us to share some of the upside of automation with our customers, but then, you know, kind of keep some of the, you know, upside for us as well.

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

And, you know, we are... This year, we've implemented...

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

um it's actually been you know uh sort of a banner year um i think uh we've booked um in this year alone um several hundred million um worth of um i guess bookings um and so are in the process of implementing a lot of that and and and so a lot of um what we track is um you know kind of the

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

The impact per customer, so the number of dollars we find corrected for the size of the customer, so dollars per discharge is one.

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

The quality of what we do, so the error rate, the fraction of charts that we're able to QA.

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

And then I think third is just our own internal cost per unit of service that we deliver.

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

Got it.

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

And so it ends up being basically you want sort of more impact at a higher quality for a lower cost.