Key Highlights
- Predictive Editing uses AI to prevent claims denials by analyzing extensive data, enhancing the provider’s submission workflow.
- A proof-of-concept study flagged over $828 million in denials with 97% precision.
- Developed in partnership with Anomaly Insights, the tool’s AI engine is designed for seamless integration, providing real-time, predictive insights to minimize denials.
Source: Business Wire
Notable Quotes
- “With Predictive Editing, providers have a tool that drives a more seamless payment process for providers nationwide through Availity Essentials Pro,” – Linda Perryclear, Senior Director of Product Management at Availity Essentials Pro
- “Our partnership with Availity provides a unique opportunity to bring advanced AI/ML capabilities directly to providers and payers to eliminate cost and waste,” – Mike Desjadon, CEO at Anomaly Insights
SoHC's Take
Predictive Editing stands as a significant advancement in claims management, offering a promising solution to the increasingly complex and costly issue of claims denials in healthcare. Its AI-driven engine, developed in collaboration with Anomaly Insights, signifies a leap towards more efficient, accurate, and cost-effective healthcare administrative practices. By automating the detection and correction of potential denials before they occur, Predictive Editing not only reduces the administrative burden on healthcare providers but also streamlines the payment process, leading to faster reimbursement and improved financial health for providers. This innovation marks a pivotal moment in the ongoing evolution of healthcare technology, showcasing how AI and machine learning can be harnessed to solve some of the industry’s most persistent challenges.
