Automated revenue cycle manager, TRISH, identifies and corrects errors

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Health systems looking to automate their revenue cycles can now employ TRISH to recognize vulnerabilities in their current system and reduce errors that impact the bottom line.

TRISH is an artificial intelligence application created by a joint venture between the Healthcare Advisory Group of Windham Brannon and Deep Indigo called SHOAR Health. The resulting company specializes in creating technology solutions for revenue cycle, operations, risk analytics and data management.

Its name stands for “Trusted Revenue Innovation for Smart Healthcare,” and it can analyze the key areas of revenue loss to seal the gaps. Because TRISH uses AI, it learns and adapts the longer it’s used, without the need for human intervention.

The application searches through the areas within a revenue cycle that are typically the most problematic, including eligibility, authorizations, pre-certification and claims status. If it finds an issue in one of these areas, TRISH can correct it, in turn freeing up staff to pursue higher-value tasks.

TRISH has been implemented in select client environments and remains available for interested healthcare organizations regardless of size or geography, according to SHOAR Health. To implement it, organizations will undergo a comprehensive workflow analysis to customize the machine learning tools to the client’s needs.


When health systems have their staff manage revenue cycles, as much as 25% of the day can be spent on repetitive tasks related to the revenue process, according to a report from FTI Consulting.

All of that time spent could amount to $200 billion in administrative waste in the healthcare system, due to inefficient revenue cycle practices, according to data cited in a HIMSS20 Digital presentation.


Kaufman Hall’s monthly National Hospital Flash Reports have shown a harrowing picture of the financial situation of the country’s healthcare organizations. In July, it reported that operating margins plunged 96% since the start of 2020. The picture in October’s report was not much clearer as higher revenues through September were offset by rising expenses of 3.5% year-over-year.

As a result, healthcare financial leaders have started looking towards technology and automation tools to help recover from the financial impact of COVID-19.

More than half of healthcare executives surveyed by the Center for Connected Medicine said they are optimistic or very optimistic that they would innovate their revenue cycles in the coming year.

Further, while all of the CFOs surveyed by Black Book recognize they will experience a significant revenue decline this fiscal year, only 12% expect they will need to cut or defer spending on their financial systems’ digital transformation.

Other digital financial services include VisitPay, which was deployed over the summer in Geisinger, a health system serving Pennsylvania and New Jersey, to help it manage its revenue cycle.


“The revenue cycle is extremely rigorous,” said Valerie Barckhoff, the confounder of SHOAR Health and an Advisory Lead for the Healthcare Practice at Windham Brannon. “HIPAA laws back in 1996 gave us an outline for how to communicate the pieces back and forth, but healthcare organizations still struggle to manage the data. Reducing errors and inefficiencies can ultimately reduce the cost of doing business for healthcare organizations, increase revenue, and allow hospitals to focus on taking care of patients.”

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