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            Artificial Intelligence (AI) IN RCM OPERATIONS  


P3 Quality is a Virtual Solutions Center (VSC), and Online Hub designed to provide a range of services, resources and support to users in the AI in Revenue Cycle Management (RCM) space. 

The p3 Approach focuses on identifying AI in RCM Pre-Implementation and Post Launch quality, regulatory compliance, and inefficiency risks. 


Artificial Intelligence (AI) and Algorithmic Automation technologies are being Implemented in all aspects of the RCM.  Here are a few high-risk areas AI is currently used in:


  • Front End: Scheduling, patient registration and eligibility verification 

  • Mid Cycle: Clinical Documentation Integrity (CDI), AI in Medical Coding, Audit and Monitoring

  • Back End:  Claims Management, Denial Management and Payment Posting



Revenue Cycle Management (RCM) leaders are dependent on Artificial Intelligence (AI) and Machine Learning (ML) accuracy and integrity to help achieve day-to-day operational efficiency and optimization goals and objectives.

In Health Information Management (HIM) and Revenue Integrity (RI) it is critically important to establish accountability, and responsibility that is designed to ensure claims reimbursement accuracy, quality and integrity.

AI and ML Automation are both used throughout the Mid RCM Operations Medical Claims Processing Lifecycle.


The p3 Quality methodology is designed to use Predictive Analytics and other RCM AI-Powered technologies to get a head start on identifying, flagging and addressing potential risks, execute error mitigation and remediation.  


Reach Out to Us.  We can help!


RCM Operations require us to pay attention to quality with Eyes On AI. AI Algorithms can help to improve data accuracy and the speed of how Patient Information is retrieved.

Our Eyes are on AI and its impact on RI and HIM Exceptions, Implications, and Opportunities!


Automated Coding Systems can assign the appropriate diagnosis and procedure codes of patient care services that help to create the medical billing statement. P3 offers AI Assistance with:

  • Automated Code Assisgment
    - Computer Assisted Coding (CAC)

  • AI-Supported Clinical Documentation        - National Language Processing (NLP)

  • CDM / Charge Capture / Reconciliation     - Machine Learning (ML)


  • Patient Encounters

  • Clinical Documentation 

  • Medical Code Assignment

  • Medical Code Review

  • Pre-Bill Edit Management

  • Claim Generation 

  • Claim Submission 

  • Adjudication 

  • Payment Posting

  • Pre/Post EHR Implementations

  • Work Queue Maintenance

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