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Revenue Cycle Management Summit 2023 Revenue Cycle Management Summit 2023
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Revenue Cycle Management Summit 2023
Moving toward Meaningful Automation & Defining Autonomous Coding

author - Dustin Cragun
Dustin Cragun
author - Jaren Day
Jaren Day
November 7, 2023 | Read Time: 7  minutes

In August 2023, KLAS hosted its first Revenue Cycle Management Summit, where revenue cycle leaders from healthcare organizations and healthcare IT companies came together to share best practices, collaborate on moving the market toward more meaningful automation, and discuss the emerging technology of autonomous coding. Drawing on insights from (1) a pre-summit survey and (2) small group discussions at the summit, this paper shares how attendees are using automation, the challenges they have encountered, and best practices for achieving short- and long-term solutions.

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The Pre-Summit Survey: Gauging the Current & Future State of Automation

To gather context for the summit’s small group discussions, KLAS randomly sampled revenue cycle leaders and asked them to complete a pre-summit survey regarding (1) where revenue cycle leaders are automating today, (2) the biggest obstacles to automation for revenue cycle leaders, (3) where revenue cycle leaders report the most ROI with automation, and (4) where revenue cycle leaders are planning to invest in automation in the next 12–24 months.

respondent job area  respondent job level  respondent organization size

Pre-Summit Survey Reveals Automation Is Most Often Used for Claims & That Cost Is Biggest Obstacle to Automation

Technological innovations and advancements are seen as solutions to current financial, staffing, and regulatory pressures, but it can be difficult for healthcare organizations to know how to leverage these technological solutions. Revenue cycle leaders want to quickly adapt to survive the market, and they are looking at automation to alleviate pain points. Respondents to the pre-summit survey shared the areas in which they are automating; some use cases were commonly mentioned—with claims processing being most frequently highlighted—while others were unique to certain organizations. Survey respondents said their biggest obstacles to automation are cost, other projects being prioritized, unknown ROI when implementing automation, and organizational resistance to change.

Note: To learn more about how summit attendees addressed obstacles and received benefits of automating in top areas, go to the Question 1 Discussion Insights section below.

top areas being automated
biggest obstacles to automation

“It is difficult to hire and find qualified staff that really want to stay and grow with companies. That is why we as an organization really embrace the automation world. We are trying to engage with AI where we can as quickly as we can so that we can survive. We are on board with AI, and it is here to stay. As a human race, we just need to embrace it and not resist because it is a sign of the times.” —Business office manager

Survey Respondents Most Often Cite ROI from Automating Claims Processes; Majority Plan to Invest in Autonomous Coding in Coming Years

Demonstrating ROI can be critical for revenue cycle leaders who need to make a compelling case for automation, especially when ROI can at times be difficult to assess. Most survey respondents realized ROI from saving employees time around claim statusing; these respondents used bot technology to reduce tedious manual workflows and eliminate wait times on the phone, which allowed them to allocate staff to new, more challenging and detailed work that requires human oversight. Due to pressures from limited staff bandwidth and limited coding expertise, more than half of respondents want to invest in autonomous coding (see Question 2 and Question 3 Discussion Insights on how users define autonomous coding and their reasons for investing in it). Although automation technology is anticipated to greatly impact the coding market in the coming years, many respondents want more information before investing, as they don’t know the initial costs or ROI.

areas seeing most roi from automation
areas for which respondents plan to invest in automation in the next 12-24 months

Summit Discussion Insights: Lessons Learned with Automation

The pre-summit survey was used to provide context for the small group discussions at the summit. Attendees in these small groups discussed four different questions (outlined in the following sections) as well as lessons learned and best practices for achieving success with automation.

What Have You Done in the Last 12–24 Months with Automation to Relieve Pain Points in the Revenue Cycle?


  • Autonomous coding, claims statusing, and prior authorization are key revenue cycle areas in which provider attendees have used automation to relieve pain points:
  • Autonomous coding reduces administrative burden and increases coding efficiency.
  • Automating claims statusing helps organizations make necessary workflow adjustments, significantly save time, and boost efficiency around handling claims.
  • Automating prior authorizations helps save time when validating whether an authorization is required per the procedure codes and when submitting authorizations.

Key Lessons Learned

  • Healthcare organizations should start small when utilizing automation—there are many opportunities but also many challenges. Organizations need to look beyond a siloed approach to healthcare technology and think in terms of end-to-end solutions. When first starting out, organizations should also focus on collaboration between departments and quick wins.
  • To help overcome unknown ROI, healthcare organizations need vendors to better provide both hard and soft ROIs and demonstrate how automation can improve accuracy, efficiency, and financial outcomes. Some customers may need their vendor to go at risk to prove ROI.
  • There are many challenges with payer-provider relationships that complicate automation opportunities, emphasizing the need for stronger alignment and collaboration that can be achieved through dialogue.

How Do You Define Autonomous Coding?


  • The definition of autonomous coding varies among healthcare organizations and vendors but generally involves automating coding processes to ensure high accuracy, reduce costs, and improve efficiency by minimizing or eliminating human intervention.

Key Lessons Learned

  • Autonomous coding is required to have at least a 95% accuracy rate, which is the standard expectation for human coders.
  • Autonomous coding is intended to alleviate staffing burdens and reduce the need for human coders. It entails the ability to code and submit claims directly from clinical notes with minimal involvement from human coders.
  • Customization and learning capabilities are important aspects of autonomous coding, allowing the technology to adapt to the guidelines and requirements of different organizations.

What Are the Main Motivations behind Implementing an Autonomous Coding Solution?


  • Staffing shortages are a top driver of revenue cycle leaders looking at autonomous coding solutions. Healthcare organizations are not looking to replace employees with automation solutions; instead, they want to bridge staffing gaps with automation.
  • Healthcare organizations want to automate repetitive, high-volume coding tasks; this would allow coding staff to focus specifically on critical coding needs that require a deeper level of expertise.

Key Lessons Learned

  • To automate tasks, healthcare organizations will need to implement training and employee development programs. Autonomous coding vendors should work closely with customers to develop a more holistic coding approach that considers both the upstream and downstream pieces that are ancillary to the coding process (e.g., refining the ambient speech technology used during physician documentation to streamline coding processes later on). As vendors do this, healthcare organizations will better understand existing gaps and what training programs should be implemented.
  • Cost is an important consideration factor for organizations looking at autonomous coding solutions; many organizations do not want to adopt a solution if it will cost more than using human coders. Ideally, coding solutions will ultimately decrease costs for organizations once they are implemented.

Question 4 Discussion Insights

How Can You Be Intentional about Your Revenue Cycle Automation Strategy Now to Achieve Better Outcomes in the Future?


  • Healthcare organizations don’t expect their workflows to go away due to automation but rather anticipate seeing manual workflows minimized. Revenue cycle leaders believe automation will lead to an evolved revenue cycle workforce where staff are repurposed and workflows are more efficient and consolidated, enabling staff to tackle more challenging assignments. Ultimately, automation will be used to enhance not only the provider experience but also the patient experience.

Key Lessons Learned

  • Before implementing automation, organizational processes need to be optimized, as that will lead to healthcare organizations achieving better outcomes and improved value.
  • Employees are often the best resources for identifying inefficient workflows and automation opportunities.
  • To achieve better outcomes in the future and move toward more meaningful automation, healthcare organizations need to address data assimilation and implementation challenges, since existing methods aren’t fully meeting their needs.
  • Effective change management is critical as automation becomes more widely adopted and employees shift to more complex roles. Organizations should implement effective communication, management, and training.
  • Actionable analytics regarding ROI are crucial for revenue cycle management automation.

Next Steps

  • Due to market energy and provider interest in autonomous coding, KLAS is currently expanding research in this area via Emerging Insights reports as well as an autonomous coding market segment to monitor vendor performance.
  • KLAS plans to host another revenue cycle management summit in 2024.

Summit Attendees

Healthcare Organizations

Adventist Health
Baylor University Medical Center
Cape Fear Valley Health System
Centra Health
Children's Hospital Los Angeles
CHRISTUS Health System
Confluence Health
Gastro Health
Gillette Children's Specialty Healthcare
Granger Medical Clinic
Henry Ford Health
Intermountain Health
Island Health
Mass General Brigham
Moffitt Cancer Center
OSU Physicians, Inc.
Stanford Health Care
Team Rehabilitation
University of Miami Health System
US Acute Care Solutions
Utah Cancer Specialists
Valley Medical Center
WVU Medicine

Software Vendors/Services Firms

Access Healthcare
AGS Health
AQuity Solutions
Iodine Software
Maverick Medical AI
Vyne Medical

author - Sarah Hanson
Sarah Hanson
author - Breanne Hunter
Breanne Hunter
author - Sydney Toomer
Project Manager
Sydney Toomer
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.