In our recent interview with Pinaki Saha, CEO & Founder at Anshar AI, he put some numbers on the problems that are commonly cited in healthcare billing and revenue. Saha shared that 40-50% of medical claims are denied, and that it can take up to 14 hours for a human to figure out how to get around the denial, so the provider often abandons the claim. Saha also suggests that doctors are spending half their time on administrative work, and that it can take ten hours to get approval for a high-cost medicine
Lots of providers are interested in how agentic AI can solve problems, but they get overwhelmed by the variety of products offered. Saha recommends picking a small project with a clear goal as a pilot. And two products from Anshar AI, PriorAuthPilot and DenialFighter, seem to fit that agenda.
PriorAuthPilot reduces the ten hours just mentioned to a few minutes by combining information from a patient’s record with evidence from publicly available literature.
DenialFighter works on the other end, reading a denial and finding the evidence that is needed to get the claim approved.
These tools appeal both to doctors—because they get claims approved without the headaches of doing the research—and CFOs. Sites can expect to take two to three weeks to perform the EHR integration. No change in workflows should be necessary; tasks are simply removed from the staff and they approve the results of the AI agents.
When it comes to things healthcare AI agents shouldn’t be doing, Saha draws the line at clinical decision making. He says that AI should not do that, but it can identify when a doctor has to be consulted in order to complete a claim.
If you’re interested in learning how you can quickly get value from AI agents at your healthcare organization, you’ll enjoy this interview with Pinaki Saha from Anshar AI. Plus, check out their special healthcare agents offer where you can choose from a catalog of 41 agents and launch in 4-6 weeks.
Learn more about Anshar AI: https://anshar.ai/
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