RCM Automation Moving to Artificial Intelligence
- Agentic AI is different from RPA. Instead of fixed rules, you set a goal (e.g., cut A/R days) and agents plan, act across systems, and adapt.
- Adoption must be staged. Move from RPA → cognitive automation → assisted AI → generative tools → agentic AI. Skipping steps fails.
- Real results exist. Early use shows lower A/R days, fewer denials, and faster cash—but only with proof, not vendor hype.
- Core value: End-to-end orchestration, dollar-based prioritization, contextual reasoning, and 24/7 scale.
- Success requires foundations. Clean data, strong integrations, human oversight, and an Automation Ops team.
- Measure outcomes, not activity. Track A/R days, denial dollars, clean claim rate, and staff redeployment.
- Bottom line: Done right, agentic AI shifts RCM from manual churn to judgment-driven work; done poorly, it creates new risk.