Artificial intelligence (AI) is the next frontier for efficiency in healthcare. Many fear that AI technology will replace healthcare professionals. While these concerns are common, many in the industry believe that AI will provide opportunities to rehumanize healthcare interactions. By automating repetitive tasks and providing new capabilities for healthcare professionals, AIcan be of enormous benefit and help make the patient experience more satisfactory.
AI Serves as Force Multiplier for Healthcare Professionals
MIT Technology Review Insights and GE Healthcare recently surveyed over 900 healthcare professionals to gain insights about how AI is impacting healthcare today. The survey found that healthcare professionals are already using AI to deliver patient care and handle back-office tasks, improving efficiency and lowering costs. It is also being deployed daily to handle functions such as:
- Data analysis
- Treatment plan prediction and development
- Administrative tasks
- Payment integrity audits
The ability of AI technology to automate repetitive, rules-driven tasks frees up valuable human hours in today’s complex healthcare delivery and administration fields. When thoughtfully implemented, AI becomes a force multiplier for overworked staff, allowing them to focus on tasks that human minds are best at, while crunching through repetitive functions faster than any human — and with no need for breaks.
Essentially, AI provides a better experience for patients two-fold. Fewer mistakes mean a better overall experience for patients, and AI’s fast capabilities allow healthcare professionals to spend more time on their patients.
AI’s capability to assist with diagnosis and treatment plans provide an easy example of how this technology can benefit patients, but back-end tasks can make just as big a difference. Let’s take a look at how using AI as a force multiplier for one administrative task can improve care and indirectly benefit patients.
Payment Integrity and Artificial Intelligence
Payment integrity is a huge issue for healthcare payers. Fraud, waste, and abuse charges constitute as much as 10% of healthcare spending nationwide. And with an estimated 80% of all healthcare claims containing at least one error, it’s no surprise that traditional payment integrity teams can only catch a small fraction of the millions of dollars in medical overbilling that occurs every day.
Healthcare payers need resources to provide quality customer service and secure agreed-upon care foro their members. With healthcare costs rising and margins shrinking, controlling costs where possible is key to meeting member expectations.
AI-driven payment integrity is the solution, but AI is resource-intensive to develop and works best at scale. That’s where Alaffia Health comes in. Alaffia Health’s AI-driven platform identifies high-cost inpatient claims likely to contain expensive fraud, waste, and abuse costs and obtains documentation related to the claim. The system then flags those claims for review and editing by an experienced payment integrity analyst. We negotiate on your behalf and present you with an accurate claim, generating substantial savings.
Our fusion of cutting-edge AI payment integrity platforms and an expert team of payment integrity professionals ensures our healthcare payer partners have the resources they need to provide the human touch — and meet the expectations of their members.
AI: Providing More Time For The Human Touch
There are dozens of use cases like payment integrity in which AI automates repeatable, rules-driven processes and frees up human personnel to do what humans do best: build relationships with their patients and customers. In GE Healthcare and MIT’s recent survey, many respondents indicated that the increase in efficiency made possible by AI gives healthcare professionals more time to focus on providing high-quality care.
The downside, according to other survey responses, is that AI has a high cost to develop and can be difficult to integrate into existing legacy systems. However, the potential benefits are too great to ignore.
Alaffia Health’s next-generation AI platform integrates seamlessly with partner systems and can scale as needed to meet your needs. And by partnering with Alaffia Health, you gain AI capabilities to combat fraud, waste, and abuse costs without the upfront cost and time to develop AI technology. Our fee is contingency-based; we get paid as a percentage of the funds we recover for our partners, so we’re driven to achieve maximum results for our partners.
We handle medical overpayment prevention so healthcare professionals can focus on what they do best — providing top-quality care. It only takes a few minutes to learn how healthcare payers can harness the power of AI to drive efficiency and control costs.