Outbound AI uses generative AI GPT to reduce healthcare's administrative costs - The EE

Outbound AI uses generative AI GPT to reduce healthcare’s administrative costs

Outbound AI uses importance of generative artificial intelligence, including GPT, to remove the burdens of administrative work across the healthcare revenue cycle.

“The amount of time medical billing teams spend on the phone with payers is truly staggering. It can easily be two-thirds of their day. This is not only counterproductive, but it’s degrading to job satisfaction and performance,” says Stead Burwell, founder and CEO of Outbound AI. “Our AI Virtual Agents are specially trained to handle routine phone-based tasks so human talent can be more strategic and get more done.”

Though many workers fear AI is destined to replace them, Burwell is committed to human-agent teaming, which pairs human intelligence with artificial intelligence to harness the strengths of each. “Our solutions are workforce multipliers,” says Burwell. “We augment human talent by performing rote tasks that are better offloaded to artificial intelligence. Our AI Virtual Agents can complete four to five times the work of an FTE at 20% to 50% lesser cost. Plus, they’re able to retrieve up to three times more data than traditional EDI.”

Since launching its claims work solution late last year, Outbound AI has expanded its capabilities to include a full suite of automations that leverage the company’s conversation AI cloud platform:

  • Enhanced claims status information
  • EOB (explanation of benefits) processing
  • Eligibility and benefits verifications
  • Prior authorisations
  • Denials management

The company’s AI Virtual Agents are able to fully navigate payer IVR (interactive voice response) systems, wait on hold, and even talk to human representatives. They also take notes and with use of GPT produce narrative summaries of every call and transaction.

“We’re not only capitalising on the capabilities of GPT, we’re doing so in a highly secure, HIPAA-compliant manner through Microsoft Azure,” says Jonathan Wiggs, co-founder and CTO of Outbound AI. “This is crucial for any company that serves the healthcare industry, especially considering the business associate agreement mandated under HIPAA is not available if using GPT directly through OpenAI.”

The ability of AI Virtual Agents to produce narrative summaries is integral to quality assurance protocols for healthcare revenue cycle management. “Narrative summaries are typically a requirement of billing team members. They don’t get credit for a call if they don’t produce one,” says Wiggs. “Our AI Virtual Agents are held to the same standards, and by using GPT, they’re able to simulate exactly how experienced billing team members do this work.”

With a tight labor market, declining reimbursements and extremely low margins, healthcare organisations of all sizes can turn to Outbound AI for a new path forward, with Conversation AI that augments human talent while markedly reducing administrative costs, improving productivity and elevating the daily job experience.

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