AI Insights

From AI-powered claims management tools to revenue cycle automation, artificial intelligence (AI) and automation in healthcare are being adopted in countless ways – and providers are already seeing the benefits.

KLAS First Look findings show strong early performance for Experian Health’s Patient Access Curator, with all interviewed customers saying they would buy again. The report highlights PAC’s ability to improve data accuracy at the front end of the revenue cycle — using automation, real-time data, and an advanced COB primacy engine to identify and correct coverage issues before they become denials.

Experian Health’s Patient Access Curator helped Columbus Regional Health (CRH) improve front-end accuracy after a vendor outage exposed workflow gaps. With Patient Access Curator, CRH reduced eligibility denials by 41%, and coordination of benefits and registration denials by 37%, while achieving 97% coverage accuracy.

Experian Health’s new denial management survey shows that preventable errors at registration continue to drive denials, making front-end data accuracy and automation essential to reduce rework, protect revenue and submit cleaner claims the first time.

Claim denial rates remain high – and in some cases, they’re rising. Experian Health’s latest Denial Management survey found that over the past 12 months, 25% of healthcare providers reported increased denial rates, while 42% saw no meaningful change.

Providers must adopt OBBBA preparation strategies and new technologies to brace for the impact of increased self-pay patients, who account for the highest percentage of bad-debt write-offs, as well as additional administrative and documentation requirements, such as stricter eligibility checks and reporting mandates.

By automating multiple patient registration checks in a single workflow with Patient Access Curator, MetroHealth cut denials by 44%, reduced rework and downstream costs, and gave staff more time to focus on higher-value tasks.

Modern revenue cycle optimization leverages AI and automation to help healthcare organizations capture revenue and maintain a healthy cash flow. This article outlines proven strategies for streamlining operations across the revenue cycle — from patient access and collections to claims and payer contract management.

Propensity-to-pay models use predictive analytics to help healthcare organizations understand patient payment behavior. Learn how providers can leverage these tools to prioritize collections, improve cash flow and reduce bad debt.