Additionally, leaning on industry groups such as state hospital associations as well as enlisting multiple healthcare organizations and technology companies to set up pilot projects are also good ideas. Provider organizations would also do well to start small, leveraging AI for their most challenging problems, such as patient collections.
Further, interoperability is critical, and as with any innovation project at the start. The underlying data infrastructure must be capable of routing the right claim-level, clinical, contract, and operational data to the models, and then route the results into operational workflows. Implementation of these models also requires a degree of change management, training, and a product-driven mindset to ensure actual value for the business is generated.
When it comes to effectively managing claim denials, it's undeniable that AI can be a game-changer. With the ability to enhance RCM efficiencies and alleviate revenue pressures faced by healthcare providers, AI has transformative potential. Payers’ use of AI has already impacted the volume of denials and healthcare leaders can’t afford to wait any longer to use AI to benefit their revenue cycle.
About the author: Amy Amick is the chief executive officer of Aspirion, a company that helps healthcare providers maximize their hospital revenue recovery. At Aspirion, she leads a team comprising over 100 attorneys, over 30 clinicians, and other healthcare professionals in serving more than 1,000 clients in 45 states. She also serves as an independent director on the boards of urgent-care software company Experity and healthcare-revenue-cycle-management firm Pendrick Healthcare.Back to HCB News
