Because of its ability to work with larger quantities of claims at one time, AI can easily group similar claims together, enabling providers to call about batches of claims with comparable issues once, rather than calling about each individual claim. This process saves time, reduces costs (including the personnel needed to make these calls) and helps speed recovery of reimbursement that might have been lost otherwise.
When AI is enhanced with ML, it can use past performance to go right to the source of issues better and faster. Suppose errors in claim mapping or missing information create a batch of denials affecting a very large batch of claims. The AI will learn from this experience and can be trained to look for similar relationships and problems. This creates better insights that ensure continuous, 24x7 process or system improvements in the claims life cycle.
Value care may still be off in a distant future. But the path to get there is already unfolding before us. Act on the trends listed here and you will have a very happy 2020 — and beyond.
About the author: Twenty years ago, healthcare and analytics were third cousins. Today, they're nearly inseparable, thanks to a unique cadre of leaders, including Brian, who shared and operationalized a vision that analytics could redefine the way healthcare is managed. Brian has been a passionate pioneer and evangelist of the power of Big Data analytics as a force to disrupt the economics and quality of healthcare in the most positive way. And after two decades of democratizing data and putting it in the hands of the people who need it most, he begins every day with the same boundless passion to help today's enterprise compete and win on analytics.Back to HCB News
