Real-time insights are a topic we and many others have discussed before. Being able to see immediately what works and what does not work is an incredible tool for organizations; especially when it comes to areas like patient experience and revenue cycle management. But how do we get these real-time insights? New tools and technologies are constantly being developed and improved in the world of healthcare. So, how do you know which ones you need to get your desired results?
In search of those answers, we reached out to our incredible Healthcare IT Today Community to ask — what tools or technologies are most effective in providing real-time insights into financial performance and key RCM metrics? The following is what they had to share.
Monte Sandler, Chief Operating Officer at WebPT
A strong business intelligence (BI) reporting solution is essential for effectively monitoring and managing the revenue cycle. Given the complexity of RCM, a BI tool helps identify trends and consolidates data to support better decision-making. Robust data management also plays a key role in applying the “shift left” approach, highlighting areas of opportunity and guiding root cause analysis so that claim exceptions can be eliminated.
Ritesh Ramesh, CEO at MDaudit
There are emerging AI tools that can visualize trends in the data and provide real-time insights into financial performance or issues. Many of these tools are embedded within EHRs or can reside outside the systems of records if there are multiple EHR systems. Modern database and analytics technologies on the Cloud can facilitate real-time analytics at scale across millions of data points and also execute algorithms and LLM (large language models) on unstructured data, which is 90% of insights within healthcare data.
Cheryl Taylor, Vice President, RCM Advisory at Cognizant
Business intelligence tools are indispensable for an organization to thrive, but they must deliver actionable insights, not just data. Key performance indicators are the guiding star of the revenue cycle, and you cannot improve without proper insight and immediate response capabilities. Leveraging AI-powered analytics to ingest 835/837 data for real-time feedback is crucial, enabling proactive intervention rather than reactive management. This represents a fundamental shift from relying on the traditional aging of accounts to reveal a healthcare system’s shortcomings or progress. Claims are processed, paid, denied, refiled, and appealed daily; thus, your reporting should not only keep you informed daily but also empower decision-making at the point of impact, where revenue is either captured or lost.
Sandhya Ravi, Principal Product Manager at AGS Health
In today’s complex healthcare landscape, real-time insight into financial performance and revenue cycle metrics is essential for enhancing cash flow, minimizing denials, and boosting operational efficiency. Business intelligence tools like Power BI, Tableau, Qlik Sense, and QuickSight empower organizations with dynamic dashboards and drill-down analytics. These platforms make it easy to track key performance indicators such as days in A/R, denial rates, clean claim rates, and collection effectiveness.
On the data infrastructure front, cloud-native data warehouses, such as Microsoft Fabric, Amazon Redshift, Snowflake, and BigQuery, paired with real-time ETL tools, offer a powerful foundation. They allow organizations to integrate EHR, billing, and payer data into a centralized, standardized, and governed platform that scales with business needs. Meanwhile, embedded analytics within EHR systems let providers monitor financial performance directly within their clinical workflows, bridging the gap between care delivery and revenue cycle insights.
Ultimately, the key to building a high-performing, data-driven RCM ecosystem is in seamlessly integrating these technologies. When done right, this infrastructure not only identifies issues as they arise but also empowers strategic, data-informed decision-making.
Sajeed Chowdhury, Director, Transformation and Innovation Services at Nordic
The most effective tools for real-time financial and RCM insights include enterprise analytics platforms, AI-driven business intelligence tools, and integrated RCM dashboards. These technologies aggregate data from EHRs, billing systems, and payer sources to deliver clear visibility into key metrics such as first pass rate, net collection rate, and other performance indicators.
Michael Mercurio, SVP of Customer Operations at CodaMetrix
EHRs contain so much data that is critical to understanding not only the patient journey but also gaps in process and opportunities for improvement across the care continuum. The ability to obtain real-time insights in meaningful, actionable ways allows organizations to adjust, adapt, and optimize both clinical and financial performance.
James Grover, President at Vyne Dental
In today’s healthcare landscape, technology is playing a transformative role in helping providers tackle longstanding revenue cycle challenges. One of the most impactful areas is reducing claim denials and accelerating reimbursements. Intelligent healthcare IT systems can automate the capture and validation of claim data before submission, reducing errors that lead to denials. Tools that integrate directly with payers allow providers to verify patient eligibility and coverage in real-time, ensuring cleaner claims from the start. Technology also enables rapid response. Advanced analytics platforms can flag patterns in denied claims, helping revenue cycle teams proactively adjust workflows and resubmit quickly.
At the core of these improvements is data, specifically, the ability to access it seamlessly across platforms. When systems are interoperable, providers can more easily compile the complete information needed to support claims and appeals, reducing administrative delays. Ultimately, technology is flipping the script from reactive to proactive — empowering providers with the data they need, when they need it.
Yusuf Qasim, President, Payments at Zelis
The current approach to denials management is a reactive one. There are countless places for providers to pull financial data from, including clearinghouses, EHRs, and other tools, none of which are a single source of truth. Reconciling financial data from these disparate locations is frequently a manual process, managed in a spreadsheet, and takes hours and resources from provider organizations already strapped for bandwidth.
Most providers don’t have the capacity to do the digging required for the full picture of financial health, especially for trends in accounts receivable (AR) performance, sources of underpayments and denials, etc. Business growth and efficiency can stall without clear, accessible financial indicators.
Bringing claims insights and payment processing together in one intuitive platform allows providers to spend less time processing data and more time optimizing their financial health and patient experiences. Armed with trends and reasons for denied claims, provider teams can easily uncover where process improvements are needed in the revenue cycle. They can quickly see the most important metrics impacting their financial health and get to the bottom of payment issues so they can take the right actions to improve operations. With faster payments and intuitive, shareable views of claims analytics accessible at the source, providers are in a stronger position to proactively manage denials and to deliver the best financial outcomes and patient experiences.
Such great insights here! Huge thank you to everyone who took the time out of their day to submit a quote to us! And thank you to all of you for taking the time out of your day to read this article! We could not do this without all of your support.
What tools or technologies do you think are most effective in providing real-time insights into financial performance and key RCM metrics? Let us know over on social media, we’d love to hear from all of you!
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