Becker’s Webinar Recap: Preventing Mid-Cycle Revenue Leakage: How Health Systems Are Using AI to Protect Integrity and Efficiency
Mid-cycle revenue leakage is one of the most stubborn challenges in the healthcare revenue cycle. Missed utilization reviews, documentation gaps, and delays in provider engagement don’t just affect reimbursement – they impact across operations, slowing patient throughput, fueling denials, and adding strain to already overburdened staff.
While many organizations attempt to patch these issues with traditional tools, those solutions often lack the speed, precision, and adaptability needed to keep pace with today’s healthcare environment. Increasingly, health systems are turning to AI technology designed specifically for clinical and financial workflows to close these gaps earlier in the care continuum.
That shift was the focus of a recent Becker’s Healthcare discussion featuring Mary Murray Moss, Executive Director of Finance, Infirmary Health and Linda Supplee, R.N., MHA, CCM, FACHE, Chief Population Health Officer, Genesis HealthCare System, who shared how their organizations are using purpose-built AI to improve revenue integrity, streamline processes, and reduce administrative burden.
Moving Beyond Legacy Tools
The panelists acknowledged that traditional, retrospective approaches to revenue integrity are reactive by nature. By the time a denial is issued or a documentation gap surfaces, the opportunity to prevent revenue loss has often passed.
AI designed specifically for CDI and UM changes that equation. By analyzing data in real time, these systems can surface high-priority cases for review, ensuring staff focus on the encounters most likely to affect financial and clinical outcomes.
Key Tactics for Reducing Leakage
The discussion highlighted several practical strategies for addressing mid-cycle vulnerabilities:
- Intervene at the documentation stage. Closing gaps before discharge reduces downstream rework and strengthens claims upfront.
- Break down silos between CDI and UM. Aligning teams creates a more holistic understanding of patient status, driving more consistent decision-making.
- Prioritize adoption, not just implementation. Successful rollouts hinge on strong change management and clear communication about how AI supports – rather than replaces – clinical staff.
Faster Returns, Fewer Tradeoffs
A recurring theme was the importance of purpose-built AI versus bolt-on or generic tools. Both Genesis and Infirmary leaders pointed out that healthcare-specific AI not only delivered quicker ROI but also minimized the tradeoffs often seen with technology adoption, such as increased clicks or workflow disruption.
By surfacing the right information at the right time, staff could focus on high-impact cases without additional administrative burden. The result: reduced denials, improved throughput, and stronger financial resilience.
Looking Ahead
For both Infirmary and Genesis, the benefits of early, AI-driven intervention extend beyond revenue. Optimized workflows have eased staff burden, supported faster patient movement, and built greater confidence in the integrity of clinical and financial processes.
As health systems continue to face financial pressures and workforce challenges, the ability to catch revenue leakage before it occurs may prove to be not just a competitive advantage, but a necessity.
Ready to learn more? Watch the full webinar HERE!