By Swapnil Jain, CEO and co-founder, Observe.AI
LinkedIn: Swapnil Jain
LinkedIn: Observe.AI
In healthcare, the patient experience begins long before a clinical encounter. For many patients, their first point of contact with healthcare organizations is through the call center, where questions about appointment scheduling, insurance details, and general inquiries can either provide reassurance or cause frustration. Unfortunately, many healthcare organizations still rely on outdated systems that create friction during these initial touchpoints. However, as the industry shifts toward AI-powered contact centers, this is starting to change, offering new potential for revenue cycle management.
Some cutting-edge healthcare providers are using AI agents to improve patient engagement, streamline revenue cycle processes, and create better experiences for both patients and agents. By automating routine tasks, organizations can allow their frontline agents to focus on what matters most: building trust, offering personalized guidance, and handling more complex issues.
Rethinking Automation in Revenue Cycle Management
Healthcare organizations have long recognized the potential for automation to improve efficiency. In the context of revenue cycle management (RCM), automation can streamline everything from appointment scheduling and reminders to verifying insurance details and processing payments. However, many traditional solutions, such as Interactive Voice Response (IVR) systems, fall short when it comes to creating a smooth patient experience.
Patients have varied preferences: older generations may prefer speaking to a live agent, while younger generations might opt for a quicker, self-service option. Traditional IVR systems often fail to meet these diverse needs of all groups, leaving patients frustrated and prompting more calls to live agents.
To address this, healthcare organizations are turning to conversational AI and automation.
Automating Routine Tasks with Always Available AI
One of the main benefits of conversational AI is its ability to automate routine, high-volume tasks such as appointment scheduling, reminders, insurance verification, and processing payments. AI agents can handle these tasks seamlessly, allowing frontline staff to focus on more complex patient interactions.
For example, AI agents answer the call with no waiting time to immediately verify insurance coverage. By automating these processes, healthcare organizations can improve patient satisfaction, while freeing up valuable time for agents to engage with patients on more pressing concerns.
Empowering Human Agents to Focus on What Matters
While AI handles routine tasks, human agents remain vital to the revenue cycle process. Agents can focus on more meaningful interactions by offloading simple inquiries to AI. Instead of focusing on fundamental questions, agents can address complex patient concerns, guide patients through insurance issues, and provide empathetic assistance for billing and payment inquiries.
“Because VoiceAI Agents handled high-volume calls, our frontline team was able to engage patients more deeply and focus on building trust,” said Manny Noyola, Patient Service Director at Affordable Care. “They could reassure patients about treatment decisions, answer questions, and provide guidance tailored to each individual’s health needs.”
This shift allowed Affordable Care’s agents to evolve from handling transactional tasks to becoming trusted patient resources. They could offer guidance on treatment options, resolve concerns, and ensure patients felt informed throughout their care journey. This approach not only improved patient satisfaction but also enhanced continuity of care, which is critical for long-term health outcomes.
“By enabling our frontline staff to focus on building relationships, we not only improved patient satisfaction but also strengthened loyalty,” Noyola added. “Patients trust our agents to guide them, which ultimately enhances their experience and supports the overall success of our affiliated practices.”
Improving Revenue Cycle Efficiency
Automating routine tasks boosts operational efficiency. By eliminating manual processes like appointment scheduling, reminders, and insurance verifications, healthcare providers reduce administrative burdens, improve workflow, and minimize errors. This leads to fewer missed appointments, faster claims processing, and more accurate billing—all of which improve revenue cycle performance.
Additionally, automation helps reduce agent burnout and turnover, often caused by repetitive tasks. When agents focus on deeper patient interactions, they feel more valued and connected to the care process, leading to improved job satisfaction, better patient outcomes, and ultimately, better financial results for the organization.
Looking Ahead: The Future of Revenue Cycle Management
As AI and automation continue to evolve, the future of revenue cycle management looks more streamlined and patient-centric. “VoiceAI Agents are going to be transformational to our business,” said Noyola. “By automating routine tasks and empowering human agents to focus on more meaningful patient interactions, healthcare leaders can drive operational efficiency while preserving the compassion that is so critical in patient care.”
For healthcare providers, the key to success is finding the right balance between automation and human interaction. AI can manage high-volume tasks that take up valuable time, allowing human agents to focus on the interactions that matter most. This improves both the patient experience and the operational efficiency of revenue cycle management, ultimately supporting profitability.