Big bank rolls out AI claims predictor for healthcare clients
One of the 10 largest banks in the country is marketing a new AI-based system aimed at flagging upcoming medical claims that are likely to court rejection by payers.
In the process the software indicates, ahead of claim submission, which information the provider should complete or correct to head off an unhappy cash-flow outcome.
Pittsburgh-based PNC Financial Services announced the product launch March 21.
The institution’s treasury-management division says the offering, PNC Claim Predictor, uses machine learning to analyze and continuously learn from existing and updated claims data.
PNC says the product integrates with EMRs, allowing users to avoid switching between software and platform interfaces.
The company cites market research showing health insurers initially reject almost $5 million a year in claims per provider, running up tabs of around $100 per claim on resubmission tasks. Further, close to half of rejected claims are never resubmitted.
PNC says the new product fits with its overall mission to “deliver fully integrated solutions and strategic services to maximize working capital, streamline revenue cycle processes, mitigate risk and gain access to capital.”
PNC counts a wide array of healthcare organizations among its clients. These include for-profit and not-for-profit acute-care systems, physician groups, billing companies, labs, ambulatory care companies, home healthcare, extended care, healthcare payers and group purchasing organizations, according to the announcement.
“We saw that our healthcare clients could benefit from an efficient way to address the challenges they continue to face with submitting claims,” says Doug McKinley, senior vice president and head of innovation for PNC Treasury Management.
PNC Financial Services, No. 6 on Bankrate’s top-15 list with $552 billion in total assets, runs PNC Bank and PNC Treasury Management. It has around 2,570 locations in 28 states and Washington, D.C.
Full announcement here.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.