At Infinx, we are transforming healthcare revenue cycle management (RCM) with AI. As our Chief Product Officer, Navaneeth Nair, explains, AI in RCM isn’t static—it operates within a continuous improvement life cycle, where human expertise refines AI’s decision-making over time.
Our AI-powered solutions take on high-volume, low-complexity tasks, allowing our human experts to focus on more intricate revenue cycle challenges. This approach streamlines workflows, increases efficiency, and enhances financial outcomes for healthcare organizations.
AI’s Role in RCM: From Document Processing to Denials Management
Our AI capabilities start with document processing, extracting key details from unstructured inputs like faxed forms with checkboxes. AI agents then populate patient records, initiate orders, and even create new records in an EHR system. Beyond data entry, AI takes on more complex reasoning tasks, such as identifying and resolving denied claims.
We employ a hierarchy of AI agents, each specializing in distinct functions. For example, an initiation agent determines the responsible payer for a claim and then hands it off to another agent trained in that payer’s specific rules. This structured approach ensures greater accuracy and efficiency in claims processing and reimbursement.
Building Trust in AI for Better Outcomes
One key challenge in AI adoption is human trust. Navaneeth emphasizes that staff members often overanalyze AI-generated outputs, sometimes overriding decisions unnecessarily. Our approach to AI—centered on continuous feedback and refinement—helps build confidence in the technology. Over time, this cycle of trust and improvement leads to better RCM performance and financial results for our customers.
AI also offers advantages over traditional human workflows by reducing variability and enabling quick adjustments through parameter tuning. This allows organizations to optimize processes with minimal disruption, improving both efficiency and compliance.
To learn more about AI agents in RCM, read the full article on Healthcare IT Today.