Hi and happy Tuesday,

Why AI is no longer optional

Initial claim denials have trended upward since 2016, averaging about 12% across U.S. hospitals.

Nearly half of practices reported higher Days in A/R in 2021. Patient collection rates fell to ~48% in 2022–2023.

Hospitals and health systems spend roughly $20 billion/year appealing denied claims.

Adopting AI is helping to prevent avoidable denials, raise clean-claim rates, and stabilize cash flow.

The 8 essential building blocks

The numbers don't lie: AI delivers real ROI

Organizations implementing AI-powered RCM solutions are achieving transformative results across every key metric.

Your roadmap to AI implementation

1. Assess your current state: Identify areas of high friction in your revenue cycle. Where are denials clustering? Which processes consume the most staff time? Prioritize building blocks that address your biggest pain points.

2. Start with high-impact, low-complexity: Begin with front-end automation and eligibility verification, quick wins that yield immediate ROI while building organizational confidence in AI capabilities.

3. Ensure seamless integration: Select solutions that complement your existing EHR and practice management systems, rather than replacing them. Integration is the #1 success factor cited by providers.

4. Scale strategically: As you prove ROI and build expertise, expand to predictive denial management, automated coding, and intelligent AR follow-up. Layer capabilities over 12-18 months for sustainable adoption.

5. Measure & optimize continuously: Track KPIs like first-pass acceptance rate, days in AR, cost-to-collect, and time-per-verification. Utilize data to refine your AI models and extend them to adjacent use cases.

Build the eight AI building blocks to prevent avoidable denials, raise clean-claim rates, and expedite cash flow, as initial denials are ~12%, many practices report higher Days in A/R, and patient collections have declined.

Next week, we'll be sharing our end-of-year State of AI in Healthcare RCM report.

See you next Tuesday,
Dino Gane-Palmer