Insurers are using AI to deny claims – so isn’t it time to start using AI to get them approved?
Few challenges loom as large in health care revenue cycle management (RCM) as the dramatic increase of denied claims by payers. For physicians and hospitals, denied claims represent more than just technical glitches—they signify increased administrative burdens, severely delayed or lost revenue, and the potential for delayed patient care.
In recent years, providers have expressed growing concern over an unprecedented surge in claims denials. The primary catalyst for this trend appears to be the implementation of AI-powered algorithms by insurance payers. These automated systems are generating denials at an unprecedented rate, creating significant challenges for health care providers to manage and respond effectively. This technological advancement has sparked debate within the health care industry regarding its true impact: does it represent progress in claims processing, or merely an expedited method of claim rejection?
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