From fax machines to machine learning: The fight for efficiency

• Modernization and efficiency: Providers are adopting next-generation solutions for scalability, automation and efficiency to overcome challenges like tighter reimbursements and labor shortages. 

• Proactive RCM: Companies are focusing on front-end optimization to reduce denials and maximize clean claims, using tools like QuickSight for real-time analytics and reporting. 

• AI and data security: AI-powered solutions are transforming manual processes, while robust data security measures and compliance frameworks like HITRUST CSF and SOC 2 are becoming industry standards. 

YARMOUTH, Maine – The HME industry is undergoing another tectonic technology shift, but this latest evolution isn’t just about keeping up—it’s about survival, industry stakeholders say. 

Faced with tighter reimbursements, labor shortages and growing economic uncertainties, providers can no longer afford inefficient workflows and outdated systems, they say. 

“The market is hitting a boiling point, with many providers frustrated by legacy solutions that fail to keep up with modern demands,” said Wayne Hudson, director of growth for NikoHealth. “More than ever, they are looking to break away from the status quo and adopt next-generation solutions that offer scalability, automation and true efficiency—without the headaches of outdated technology.” 

The cost of inefficiency 

The cracks in outdated billing and claims processes are growing, and providers can no longer afford to patch them with manual fixes. Denials and missing documentation don’t just slow down operations—they drain revenue. 

A growing industry shift toward proactive revenue cycle management (RCM) is reshaping how claims are handled, says Amie Barone, CEO of ACU-Serve. Rather than simply processing claims, companies like ACU-Serve focus on front-end optimization—refining intake, insurance verification and business rule settings to reduce denials and maximize clean claims from the start. 

“Another critical advancement is real-time analytics and reporting,” said Barone. “ACU-Serve uses tools like QuickSight to track trends in clean claim rates, denial rates and AR over 90 days, providing clients with clear visibility into their business performance.” 

90s meets AI 

Even those who once clung to older technologies are beginning to yield—not merely out of preference, but necessity. 

“The new generation of employees doesn’t want to use software that looks like Windows 95,” said Hudson. “They expect a sleek, user-friendly platform that integrates seamlessly into their daily workflow.” 

Yet beneath the surface of even the most polished interfaces lurks a stubborn relic: the fax machine. Despite a digital-first world where instantaneous communication is the norm, patient intake often remains trapped in analog limbo. 

Fax or manual methods still account for 92% of customer intake, says Addison Perrymond, head of product management at Brightree. Brightree is addressing this by deploying AI-powered Optical Character Recognition (OCR), transforming static faxes into immediately usable data. 

WellSky, which recently acquired Bonafide, is also trying to minimize manual intervention at every stage by, among other things, proactively flagging missing information and verifying document accuracy against payer standards, says Tim Ashe, chief clinical officer at WellSky. 

Data defenders 

With cyberattacks targeting health care organizations at an increasing rate, providers are under pressure to safeguard patient data while maintaining compliance with stringent regulatory standards. 

To that end, David Schaer, president of Computers Unlimited, says security is being addressed through robust data encryption, multi-factor authentication, secure cloud storage and compliance with HIPAA regulations to protect patient information. 

Some business systems developers like ACU-Serve and Prochant are adopting comprehensive security frameworks, offering a certifiable approach to data protection. These certifications require third-party audits and ongoing monitoring, ensuring companies follow strict cybersecurity practices over time. 

“Compliance frameworks like HITRUST CSF and SOC 2 are becoming industry standards to ensure data security and regulatory compliance,” said Joey Graham, CEO of Prochant. “Providers must also work with partners who prioritize cybersecurity and invest in advanced threat detection to safeguard sensitive information.” 

• For a round of up of all the technology the industry has to offer, check out the Product Spotlight on business systems in our April Digital Edition.