4 Cornerstones for Successful AI Implementation in Hospital Revenue Cycle Management in 2025

HIT Consultant December 10, 2024
Jim Bohnsack Chief Strategy Officer at Aspirion

In recent years, payers have increasingly turned to artificial intelligence (AI) as a tool to streamline claims processing, accelerating the deployment of rules related to prior authorizations and medical-necessity assessments. Providers believe this has been a key driver behind a corresponding surge in claims denials, as well funded payers leverage technology to rapidly render these determinations and send them back to hospitals.

This trend has providers looking to respond with a tried-and-true strategy: Time to beat ’em at their own game.

Industry consolidation has given larger payers more capital to invest in payment-integrity technologies, including advanced algorithms and rules-based systems to systematically deny claims. Payers justify this approach as a response to “bad actor” providers who they believe order...

Today's Sponsors

Today's Sponsor