AI in RCM | Promises vs. Reality
The Promise:
AI will catch documentation or coding errors and prevent denials universally
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Reality:
Payer rules change constantly; establishing critical quality and compliance AI policies, procedures, and protocols is optional. CDI and medical coding inconsistencies are known issues, and denial rates remain high.
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Another Promise:
Deploy AI Automation Solutions, and you will see RCM ROI results quickly
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Reality
These Implementations often stumble due to legacy system issues, fragmented workflows, misaligned goals, and/or vendor overpromises. ROI suffers because there is no tactical rebound implementation strategy in place.
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About the Leadership
Ms. Collins is the Founder of a patent-pending AI Technology. She also serves as the Principal and Managing AI Consultant of P3 Quality, with nearly two decades of expertise in Senior Mid-Revenue Cycle Management leadership. This includes working with AI-Powered Health Information Management (HIM), Revenue Integrity (RI), and Clinical Documentation Integrity (CDI) systems. She specializes in AI data quality, compliance, and completeness. Ms. Collins is passionate about establishing and supporting Responsible Artificial Intelligence (RAI) ethical principles and frameworks that focus on implementing Next-Generation Best Practices for Automation.
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AI is set to Radically Change Revenue Cycle Management (RCM) consulting over the next five years. Automation Enhancements of routine functions, quality improvements, compliance enhancements, and decision support will take center stage. The Consultant's role is shifting from traditional leadership to serving as a strategic partner, focusing on AI Optimization, Governance, and Benchmark performance oversight.
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Systems Use of AI and Algorithmic Knowledge & Expertise ​
Epic (HB/PB)
Cerner (Soarian)
3M
OneContent
eClinical Works
MedAptus
ClinicStation
Meditech
AllScripts (Misys)
NextGen
Athena
McKesson (HPF)
Compliance 360
Citrix
ChatGPT
Google Gemini
Microsoft Co-Pilot
GenAI, ML & LLMs
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Ms. Collins holds a Bachelor of Science in Health Information Management (BSHIM) from Western Governors University and an Associate of Applied Science in Health Information Technology (AAS) from Western Nebraska Community College. She is a Registered Health Information Technician (RHIT), Certified Revenue Cycle Representative (CRCR), Certified Coding Associate (CCA), Certified Artificial Intelligence Medical Coder (CAIMC), Certified Artificial Intelligence Professional (CAIP), Certified Scrum Master (CSM), ISO 9001 Certified Internal Auditor and Approved ICD-10-CM/PCS Trainer.
The designations earned underscore Ms. Collins' commitment and dedication to AI in RCM System Excellence and Best Practices. ​​​