MEDICAL TECHNOLOGY BY CB Insights
How Artificial Intelligence Is Reshaping Medical Billing & Insurance
Artificial intelligence is helping healthcare providers save money and improve efficiency in billing and insurance. From speech recognition for clinical documentation to machine learning for data extraction, here’s how the tech is improving medical financing. Manual, repetitive tasks in billing and insurance processes can be exasperating and costly for providers. Artificial intelligence could help. In recent years, AI tech has gained popularity as a solution to combat care team burnout and cut operational costs -improve ments made more necessary by the financial and mental stress caused by Covid-19. For example, natural language processing (NLP) can automatically translate physician notes into billable medical codes, while researchers are developing algorithms that use historical data to predict the likelihood that a claim will be denied. AI in medical insurance is gaining media attention as health teams continue to realize its potential to improve billing and insurance tasks.
Below, we explore 3 ways AI is transforming the healthcare billing and insurance cycle: AI for prior authorization, NLP for automated medical coding, and AI-powered robotic process automation (RPA) for claims management.
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ASIA PHARMED & HEALTHCARE THAILAND
KEY TAKEAWAYS Artificial intelligence can help optimize backend systems. Administrative workflows, such as filing claims or medical coding, are one of the leading costs for healthcare systems and causes of burnout. AI can help automate and optimize these workstreams. Recent advancements in NLP are streamlining the billing and insurance cycle. Significant progress in inter preting medical documentation has been made with language models from Google and OpenAI. Healthcarefocused open source NLP tools have also been released for developers such as Amazon Comprehend Medical and Google’s Healthcare Natural Language API. AI solutions in administrative automation will largely depend on electronic health record (EHR) data. Medical coding solutions use EHR notes to translate health services into billing codes, and AI-powered RPA platforms can extract data from EHRs to populate claims forms.
