Alaffia Health’s Post

Did you know? "Moderate claims decreased from 60% in 2004 to 45% in 2021, while higher-intensity claims increased from 19% to 37% in the same period." At CodaMetrix, we believe that human beings will always be the number one resource for managing complexity in healthcare. We leverage human expertise with AI to address these shifts and revolutionize the revenue cycle. #CodaMetrix #HealthcareAI #ClaimsManagement #thefutureofhealthcare #ai #healthtech #healthcaretechnology #healthcare #healthcareinnovation #aiinhealth #aiinhealthcare #codelesscaremore #codingautomation #medicalcoding #healthcaretrends #equitablepatientcare #valuebasedapproaches  #healthcaretransformation #TransformingHealthcare #autonomousmedicalcoding 

#Artificialintelligence offers unprecedented opportunities to enhance #patientcare, streamline #clinicaldocumentation, and support medical decision making. More and more #healthcareprofessionals find themselves caught between rapidly changing regulations and documentation requirements, leaving them less time for what they care about most. Can AI be the key to providing physicians and other clinicians more opportunities and time to spend with their patients? In this article, my Ankura colleagues Jacqueline Voss, Lisa Taylor, JD, CCEP, CHPC and I discuss five key considerations and recommendations that healthcare organizations and those at the bedside must consider as they adopt AI.

How GenAI Technology is Reshaping the Healthcare Landscape | RBCCMGenAI technologies can drive better patient outcomes, operational efficiency and cost savings. The adoption of generative artificial intelligence ( ...https://lnkd.in/eBpxAWGv

While AI has the potential to streamline processes, its current use in the revenue cycle is resulting in more claim denials, payment delays, and a greater need for appeals, particularly because payers often use AI to retroactively review medical necessity determinations. #revenuecycle

Not So Shiny and Not So New We are so easily tempted by novel and exciting solutions… A slick, new EMR. A cool tool for revenue cycle management. A mobile app to accelerate staff orientation. And the most tantalizing of all solutions…. AI. Don’t get me wrong, I get excited about new stuff as well and I particularly like AI because it is so easy to spell. It is worthy to note that all of these concepts have the added allure of being an externally generated solution. All we have to do is pay the monthly subscription for the Wiz-bang Gadget of the Month Club and results are just moments away! These solutions (some of which do add value for sure) are like weight-loss drugs for healthcare operations. In reality, I think we may need to turn our attention to the not-so-alluring internal solutions first. Or in other words, let’s hit the treadmill of conditioning with a clear-eyed focus our culture and the support of our people. Let’s put some time in the weight room of making our processes clearer and more efficient, ensuring the safety of our staff and patients, and improving customer experience through better trained staff and elevated service. It isn’t easy but it will pay off dividends for our staff, our organizations, and, most importantly, our patients long after the gleam of the shiny new gadget has worn off. Please share your thoughts and comments below.

#Healthcare executives gathered at the #HFMA 2024 Annual Conference in Las Vegas from June 24-27 to address pressing challenges in healthcare revenue management. Like many other conferences this year, the theme underscored the industry's maturity in AI and the urgent need for healthcare #CIOs to harness AI tools swiftly. However, the solutions all look alike, and it is hard to differentiate unless you look under the covers or tell the story differently. https://lnkd.in/gvepQBuP

Happy to share my latest blog post on the Brillio website: "Better healthcare, brighter futures with Gen AI". For an Industry over-burdened with administrative duties and paperwork, encumbered by staffing shortages, can Gen AI come to the rescue? In this blog we explore some of the major challenges the Healthcare Industry faces today, and how Gen AI can potentially revolutionize the operations of the various segments that form the Industry. (Big Pharma, Payer and Care Providers) Read the full article here: https://rb.gy/pb9sbv #GenerativeAI #Healthcare #Brillio #BlogPost

The CBO is smart to take a closer look at the existing capabilities as well as risks to moving too quickly in the healthcare artificial intelligence space. These discussions have ranged from exploring the role of artificial intelligence (AI) and machine learning in healthcare, focused particularly on predicting patient outcomes and managing costs. They also evaluated specific legislative measures aimed at reforming pharmacy benefit management (PBM) practices. One section in particular highlighted the uncertainty of impact of AI on healthcare costs and the potential savings from reforms like banning spread pricing in Medicaid, estimated to save $1.1 billion over a decade. Healthcare is ripe for innovation in the process and transactional space, I look forward to the maturation of AI tools and their potential use cases. Anyone out there using off the shelf tools? Or are you taking advantage of integrated options available from the large software suites?

Can AI help increase the efficiency of in-network claims reviews? Absolutely, but not on its own and not without real people reviewing claims. Check out our latest blog as we dive into AI’s influence in claims review:  https://lnkd.in/ebJCBM3t

With shrinking reimbursement, increasing fees, the threat of closure and more, the US community pharmacies are facing major challenges. However, as artificial intelligence (AI) develops, there are new opportunities for pharmacies – particularly when it comes to a cash pricing strategy. Learn more: https://bit.ly/3VQEjo8