5 Key RCM Challenges for NextGen Users and How Thoughtful AI Solves Them

Generating summary

Revenue cycle management in healthcare is becoming increasingly complex. As claim volumes rise and regulations evolve, many practices using NextGen EHR find themselves struggling to keep up. Automating administrative tasks has become crucial for maintaining efficiency and financial health. Here are the five most common challenges NextGen users face and how Thoughtful AI's solutions can help overcome them.

Slow System Performance

NextGen users often grapple with slow system performance, particularly when processing claims. This leads to extended processing times, typically ranging from 5 to 10 days. Such delays can significantly impact cash flow and overall financial health. Thoughtful’s AI Agent CAM addresses this by automating the claim submission process. By integrating with NextGen, Thoughtful AI can reduce claim processing time to just 24-48 hours. This dramatic improvement in speed not only enhances efficiency but also accelerates reimbursements, positively impacting your practice's financial stability.

Inefficient Denial Management

NextGen's built-in denial management tools often fall short, leading to high denial rates. This inefficiency can result in substantial revenue loss and create a backlog of unresolved claims. Thoughtful AI's advanced denial management capabilities can reduce denial rates by up to 75%. By automating the tracking, resolution, and resubmission of denied claims, Thoughtful AI helps practices recover more revenue and optimize their financial outcomes.

Complex Customization

While NextGen offers a range of features, customizing workflows can be challenging without causing performance issues. This complexity often leads to inefficiencies in managing RCM tasks and can increase the likelihood of errors. Thoughtful AI seamlessly integrates with NextGen, allowing for customized RCM workflows without the glitches or slowdowns typically associated with complex configurations. This integration ensures smooth operations while reducing the need for intricate setups, allowing your team to focus on more value-added tasks.

Integration Challenges

As practices grow and claim volumes increase, NextGen users often struggle to integrate their EHR system with third-party RCM solutions. This lack of smooth integration can create data silos and hinder scalability. Thoughtful AI excels in cross-system integration, facilitating seamless data flow between NextGen and other RCM systems. This capability allows practices to scale their RCM operations effortlessly, even as patient and claim volumes grow. By breaking down data silos, Thoughtful AI provides a more comprehensive view of your RCM performance.

High Manual Workload and Errors

NextGen users frequently face a high manual workload in their RCM processes, leading to frequent errors in billing and other critical tasks. This not only increases the risk of claim denials but also puts a strain on staff resources. Thoughtful’s AI Agents significantly reduce the manual workload, automating up to 80% of repetitive RCM tasks. This use of AI and automation leads to a 95% reduction in manual errors, resulting in cleaner claims and fewer rejections. By freeing up staff time, your team can focus on more complex, high-value activities that require human expertise.

Guiding Principles

The impact of integrating Thoughtful AI with NextGen is substantial. Practices typically see a 3-5x ROI within the first two years, along with a 40% decrease in operational costs due to reduced staffing needs. Moreover, the reduction in claim denials leads to improved financial outcomes across the board.

As the healthcare landscape continues to evolve, particularly with changes in Medicare Advantage and other regulations, having a robust, adaptable RCM solution becomes increasingly crucial. By augmenting NextGen with Thoughtful AI, practices can navigate these changes more effectively, ensuring they stay ahead in the ever-changing world of healthcare finance.

Leveraging AI for enhanced revenue cycle management is no longer just an option—it's a necessity for practices looking to optimize their financial performance and streamline their operations. By addressing these five key challenges, Thoughtful AI not only enhances the capabilities of NextGen but also positions healthcare providers for long-term success in an increasingly competitive and complex healthcare environment.

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Published On:

January 10, 2025

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