With ever changing healthcare regulations, how can you save time and resources while increasing your patient pay collection potential?
ImagineAI™ is the artificial intelligence you need to streamline the medical billing process. Automated within ImagineBilling, this rule-based solution helps identify appropriate patient coverage, evaluates the patient’s ability to pay and customizes your billing messaging and methods for patient payment. Reduce denials and number of patient statements sent with advanced Eligibility and Propensity to Pay logic.
Charge Capture: ImagineAI™ validates existing patient insurance, checks eligibility and completes ID verification.
Patient Billing: The AI engine then determines propensity to pay and financial aid options for the patient.
Patient Follow-up: Based on the patient billing evaluation, the final step in the engine is to configure the number of statements and write-off rules.
Step 1 (Setup) — User sets up location rule to enable ImagineAI™ Eligibility services for their practice. The "EligibilityVisitCreatedThreshold" setting allows the ImagineAI Eligibility check to pull visit information for evaluation at a default of 6 months. This setting prevents the system from running unnecessary checks on outdated visits.
Step 2 — The Eligibility task will first look at the primary insurance listed on the visit, if any. If the patient visit does have a primary insurance listed, ImagineAI™ will validate eligibility for that specified payor. If the patient is eligible for the specified payor, ImagineAI will gather and return the relevant data. If the patient is not eligible for the specified payor, ImagineAI will run an ID Verification check.
Step 3 — If ImagineAI™ discovers that a patient is not eligible, it will then run an ID Verification check for the patient and will return the patient’s current demographic data.
Step 1 — Set up "Financial Service – Propensity to Pay" task. This will assign a patient score based on his or her payment history recorded in ImagineBilling. Five grades are established in this section ranging from "A - Very High" to "D - Very Low" based on the patient’s payment history. The score will indicate how likely a patient is to pay his or her current balance based on his or her history of payments. If the patient has a current internal score of ‘B,’ ‘C,’ or ‘D,’ or if the patient does not have an internal score at all, then Imagine will check to see if the patient has Medicaid. If the patient does have Medicaid, the system will not run an ImagineAI Propensity to Pay check. If the patient does not have Medicaid, Imagine will flag the patient as needing a new score and will place the account on a statement billing delay. This check saves you from running unnecessary checks on patients who regularly pay bills in a timely manner.