Introducing interactive voice recognition, chatbots, and automated text messages can provide a personalized touch and make stakeholders feel comforted about the progress of their case. With an ever-rising number of claimants, communication can be overwhelming as there are multiple touchpoints. Here’s why AI/ML is the best bet for claims management: Taking this a step further is using artificial intelligence (AI)-based systems that can weed out administrative liabilities through cognitive decision-making. Additionally, predictive analytics models could forecast the actual payment that can ultimately deliver a better experience for patients and providers. When applied with advanced analytics techniques and visualization tools, you can extract information from varied sources while maintaining the quality of the data and producing the most relevant output to the final user. Today, there are tools available that come with cognitive capabilities to help sift through unstructured data. Often, payers and providers slice and dice data based on their particular requirements, but it may be prudent to aggregate patient data in a manner where patient data is linked together for easy access by stakeholders. It can be both time-consuming and layered. Every case brings with it a humungous volume of data that needs to be analyzed, verified, and approved for processing. Ultimately it all crystalizes down to data. The use of AI/ML could bring about a paradigm shift in the payer-provider equation, and when used well, it can make these stakeholders sync up as partners working towards a fruitful outcome. One of the biggest challenges that healthcare organizations continue to grapple with is the payer-provider disparities.
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