Streamlining Complex Healthcare Billing Workflows using Cloud ERP

Abstract

Cloud-based enterprise resource planning (ERP) systems offer transformative potential for streamlining and optimizing complex healthcare billing workflows. This paper examines how leading cloud ERP solutions address key steps across the healthcare billing lifecycle including claim generation, coding, insurance verification, submission, payment posting, collections, and financial reconciliation. It evaluates specialized capabilities in these systems for fee schedules, payer contracts, coordination of benefits, patient invoicing, analytics, and regulatory compliance. The paper also explores how artificial intelligence is being incorporated into cloud billing platforms through automation, virtual agents, and predictive analytics. Recommendations are provided for configuring and adopting cloud ERP tailored for healthcare environments. The paper highlights measurable improvements achievable in denial rates, cash acceleration, cost reductions, and revenue cycle performance. However, successfully leveraging these systems requires navigating the intricate rules, regulations, and integration needs inherent to healthcare billing