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How AI can streamline health care claims processing and benefit payers

AI is constantly learning and improving in order to better meet brokers’ needs; meanwhile, the claims process continues to evolve in the digital age.

By Dr. YiDing Yu | January 27, 2021 at 10:31 AM
While the health care industry is witnessing a record-breaking year in digital health investments, the AHA simultaneously projects healthcare’s financial losses to total over $300 billion in 2020. This indicates that while the pandemic has severely impacted the financial well-being of health care institutions, they’re increasingly turning to digital and artificial intelligence (AI) solutions that streamline behind-the-scenes functions and alleviate administrative and operational spending.

Many hospitals are seeing immediate results from these investments in departments and functions that involve error-prone, repetitive, time-intensive tasks. One function fraught with such tasks is claims processing and reimbursement.

Although claims processing and reimbursement is a crucial piece of the health care revenue cycle, it involves a myriad of stakeholders and steps, such as validation, justification, authenticity, and payment. Each step of the process is just as crucial as the last, making efficient and accurate communication across every stakeholder critical for success.

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