AI Agents for Healthcare RCM Billing Automation

Reduce the burdens of claims follow-up with transformative AI services

If your billing organization struggles with the time and effort it takes to resolve exception-based and denied claims, you are not alone. The volume and magnitude of phone calls, faxes and portal queries is staggering, and only serve to hinder collections, deplete margins and negatively impact the human work experience.

What if there were a less costly, more efficient way to do this that that complements your existing billing systems and clearinghouse solutions while offering a greater amount of data and full transparency?

With billing AI from Outbound AI, you can “hire” AI agents to perform claims follow-up work for you, allowing your team members to be more effective in prioritizing tasks, more strategic in the claims they give their attention, and better equipped to handle a larger workload. AI agents are available 24/7/365. They scale on demand to meet fluctuating volumes and operate at four to five times the pace of their human counterparts, making them 80% less costly on average. Implementation is fast and easy, with out-of-the-box support for most major payers. Capabilities include:

• Retrieve enhanced claim status data (up to three times more than 277 EDI).
• Obtain EOB statements (full PDFs plus discrete service line data including payer-specific remarks and reasons).
• Verify eligibility and benefits (especially valuable when EBV is identified as reason for claim denial).
• Assist your billing team members with calling payers and waiting on hold (a significant productivity and morale boost).

Our Claims Work solution is tailored to meet the needs of IDNs/health systems, physician groups of all sizes, RCM/billing companies as well as EHR and other complementary technology providers.