Using AI to Appeal Denials Three Times faster – and Recover Lost Revenue

Using AI to Appeal Denials Three Times faster – and Recover Lost Revenue

EmpowerMe, a healthcare provider services organization to more than 1,000 senior living communities across 38 states, regularly receives denials from its insurance company on procedures or treatments they should cover.That means staff members have to go through the lengthy process of appealing these denials in order to get money the healthcare organization should be receiving.This was incredibly time-consuming and required certified clinicians to spend hours understanding each individual case to draft and submit the appropriate appeals. With the industry suffering a labor shortage, the problem was even more challenging.The proposal from Crosby Health, vendor of an artificial intelligence-powered technology called Apollo, was to handle most of the work of drafting appeal letters for EmpowerMe.

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The technology has completely revamped EmpowerMe and saved the organization time and team bandwidth, Mitchell reported."Healthcare organizations must solicit feedback from clinicians and all staff to identify areas for improvement and optimization.". "By fostering a culture of innovation and continuous improvement, health systems can harness the power of AI to streamline processes, enhance quality of care and improve patient outcomes."


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