AI technologies are playing an increasingly critical role in the healthcare industry – for providers, patients, professionals, and payers alike. Artificial Intelligence technology is advancing quickly and creating new leverage points for administrative processes, research and development, diagnosis and treatment, and access to care.
Alaffia Health outlines major AI technology application trends to look for in 2022 and details how AI technology in healthcare payments will help payers perform in an ever-changing healthcare market.
What is AI?
Artificial Intelligence is a type of computer technology that allows machines to perform tasks that in the past would have required human expertise . These technologies automates a wide variety of processes and tasks, including data analysis and management, accounting and billing, managerial work, research and development and more. AI technologies can process visuals and sounds, analyze vast amounts of complex data, and even make decisions.
AI Technologies in Healthcare: Today & Tomorrow
Data Analysis & Management
AI technologies will continue to have a huge impact on data analysis and management in the healthcare industry. The sheer volume of data produced in healthcare — especially in lieu of rapidly changing treatment technologies — makes manual processing, reporting, and tasks like fraud prevention or reconciliation increasingly more complicated. The application of innovative AI technologies to automate data-powered tasks will become essential for healthcare payers. These advances will empower payers to efficiently process payments, detect fraud, waste, and abuse charges, and service plan members’ needs across multiple channels in a timely fashion.
Daunted by the process of integrating AI technology in healthcare payments, many organizations will choose to partner with companies who already offer AI capabilities. Alaffia Health uses machine learning, automation, and other AI technologies to assess high-cost claims for fraud, waste, and abuse charges, helping healthcare payers prevent errors and overpayments. Alaffia Health’s payment integrity analysts then review claims flagged by the initial AI technology audit, using their subject matter expertise to ferret out expensive overcharges.
These technologies are expensive and time-consuming to develop and to implement. But we expect reliance on AI technology in healthcare payments with vendors such as Alaffia Health to continue to expand in 2022.
Healthy Habits & Preventative Care
AI technologies, paired with machine learning, will continue to enable researchers to access vast amounts of patient data and analyze a myriad of different health patterns. By leveraging AI technologies, researchers can use data to determine courses of action that will allow a larger percentage of patients to live longer, healthier lives. Emerging AI technologies also allow providers to develop personalized care plans based on huge amounts of anonymous patient data.
Increasingly AI technologies and the Internet of Things (IoT) will be utilized to help people stay healthier and meet wellness goals. Internet-connected medical devices, hardware, and software applications used to link healthcare information technology to people continually grows, making it more accessible than ever. Smart AI technologies will continue to grow in popularity as more and more smartphone companies standardize fall detection, heart rate tracking, oxygen monitoring, and more.
Preventative medicine will also be deeply impacted by AI technology in the coming years. With more data, healthcare professionals can predict where outbreaks of contagious diseases will occur, monitor hospitalization rates, and link lifestyle factors like diet, exercise and environment to health outcomes. Emerging AI technologies make it possible to create tools that spot patterns across huge datasets far more effectively than traditional analysis, leading to more accurate predictions and, ultimately, better patient care and outcomes.
Drug Development & Discovery
AI technologies are not only incredibly beneficial in analysis, but in the development and discovery of new drugs. Research, development and trials for pharmaceuticals can take years – often decades – and cost billions of dollars every year. The use of this evolving technology in drug development and discovery speeds up these processes, leading to cost savings, and a wider variety of pharmaceutical treatment options for patients.
The innovation of COVID-19 vaccines by companies including Pfizer, Moderna, and Astrazeneca since the beginning of the pandemic is just one example of how AI technologies are being leveraged to develop new treatments. Researchers can – and will – use AI to simulate molecular and cellular tests more rapidly and effectively than ever before, enabling scientists to process thousands, even millions, of simulations for analysis. And, AI-enabled modeling can eliminate months of research, reducing the time to develop, test, and distribute new lifesaving treatments.
The acceptance and integration of AI in healthcare will continue to evolve and grow in drug discovery and development, in 2022 and into the future.
Telehealth & Patient Care
AI technologies proved essential as telehealth became crucial for both rural and urban communities in 2020. Within the first months of the pandemic, the percentage of remote healthcare consultations increased from 0.1% to 43.5%. And studies confirm that most patients are happy with remote treatment and plan to continue to use virtual healthcare visits.
The benefits of AI technologies in telehealth are undeniable. Pandemic notwithstanding, developing more, better capabilities to examine, diagnose and treat patients remotely dramatically expands access to medical treatment to underserved populations.
Telehealth and AI technologies will continue to expand access to healthcare in 2022 and beyond. However, with more patients and new services come new data, new codes, new procedures — and more chances for human error and fraudulent charges — for healthcare payers. Increasingly, healthcare payers will need to leverage AI technologies and seek partnerships with payment integrity specialists like Alaffia in 2022 and the future.
Leveraging AI technologies in 2022
AI technologies are already improving workflows and operations, assisting medical and nonmedical personnel with repetitive tasks, helping patients find answers faster, empowering providers to diagnose more quickly, and developing innovative, lifesaving treatments and medicines. Patients, providers, and payers will continue to benefit from the leveraging of AI technologies in 2022 and beyond.
For those looking to leverage AI technology in healthcare payments in the coming years, choosing Alaffia Health for your payment integrity partner is key. After all, an estimated 80% of healthcare claims contain at least one overcharge. Alaffia Health’s AI platform integrates seamlessly with existing systems to prevent overpayments, errors, and fraud.
The ubiquity of AI technologies in modern healthcare will only continue to grow. Don’t be overwhelmed — start by partnering with Alaffia Health. Prevent overpayments and leverage AI for the benefit of your members and your bottom line. Learn more today!