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Work Smarter, Not Harder: How One Rev Cycle Leader Leverages Technology

Analysis  |  By Jasmyne Ray  
   December 05, 2023

Ease of use and accessibility in the front end are crucial and affects the quality of your organization’s patient experience.

When Ariana Urquia joined the executive leadership team at Florida-based Nicklaus Children’s Hospital in 2019, she recognized the need for the hospital to embrace technology.

As vice president and CFO, she found that revenue cycle challenges like poor prior authorization processes, increased clinical denials, and coding underpayments were costing the hospital money.

Urquia knew that those challenges needed to be streamlined as soon as possible not only to save on the bottom line, but to improve the patient experience too.

“It’s almost impossible to be able to tackle all of those issues without some type of [technological] solution,” Urquia told HealthLeaders.

How was it done?

In 2020, the hospital partnered with a revenue cycle management company to implement its technology within its billing and collection processes. By leveraging technology and AI solutions, organizations can reallocate their in-person staff to focus on more complex tasks within the revenue cycle, for example, denials management for complex cases or authorizations.

Another way the hospital has leveraged technology has been their charge capture solution, which evaluates patients’ medical records and checks them against the charges listed on their bills.

There are also CDI specialists that review special cases to ensure appropriate documentation.

“We use tools to help prioritize which patient accounts we should be looking at,” Urquia said. “Based on the documentation that exists in the medical record at a point in time and other parameters to say ‘Hey, you may want to take a look at this account.’”

As a children’s hospital, families largely rely on the hospital’s services, so ease of use and accessibility in the front end are crucial.

Urquia explained that while in the past, patients would complete the registration process when they arrived. However, after introducing the concept of a positive patient experience, there are more efforts to make the process more efficient to cut down wait time.

“As we start evolving as an industry and you start thinking of patients as consumers of healthcare and start really thinking about how technology can help leverage this,” she said. “We can continue to think about how we’ve always done things before and just layer technology on top of that to improve efficiency or we can just look at it in a completely different way.”

Another initiative the hospital has launched is their digital front door, which allows patients to complete their registration at home, including uploading insurance information.

While some patient’s families prefer to complete the registration process before their appointment, others still prefer to speak with an actual person; which shows in person interactions are still an important part of patient experience.

“For us, this really means it’s not taking one thing away from the other or replacing,” Urquia said. “But it’s really providing different options for patients so that we can meet them where they’re at.”

Meeting patients where they are and providing solutions like these helps the revenue cycle flow from the front end to the back end seamlessly.

Jasmyne Ray is the revenue cycle editor at HealthLeaders. 


Urquia knew that revenue cycle challenges needed to be streamlined to help the hospital financially and improve patient experience.

Leveraging technology and AI solutions allowed the hospital to reallocate their in-person staff to focus on more complex tasks within the revenue cycle.

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