Palo Alto, Calif.-based Stanford Health Care incorporates an intentional process for evaluating, implementing and monitoring new technologies, particularly artificial intelligence. To this end, a new AI tool has led to meaningful results in billing practices, Aditya Bhasin, vice president of software, technology and digital solutions at SHC, told Becker’s.
SHC, which has long leveraged AI to solve clinical issues, developed the new tool to streamline billing practices while improving staff wellness and the patient experience.
“We started talking to our partners in the revenue cycle and looking at the volume of messages that come to [billing representatives],” Mr. Bhasin said. “It’s a complicated space. Patients are anxious when it comes to billing. The questions our billing representatives receive cover a wide range of issues — services covered under the insurance plans, coverage for specific procedures, their out-of-pocket costs, payment plans. The staff has to take into account guarantor relationships, dependent coverage, negotiated discounts, patient deductibles, recent payments and a lot more before responding.”
He noted that the process consumed significant time per inquiry, with representatives handling hundreds of messages daily. For each inquiry, staff members navigated multiple screens to gather relevant information. They then selected content from among two dozen templates to begin a response, inserting the necessary information, editing and personalizing it before sending.
With these challenges in mind, SHC developed a tool that uses AI to draft responses by processing data buried across multiple modules and screens in the billing system.
“That’s essentially what this solution ends up doing,” Mr. Bhasin said. “We look at who’s sending the message, who the guarantor is for that account, which insurance is involved, what the deductibles are — and we help them create a draft response for that query.”
The AI-driven tool, which the health system piloted for two months and fully implemented in March, automatically generates draft responses to patient queries. Billing representatives then review and edit the responses to ensure accuracy.
Mr. Bhasin also noted that the tool — custom-built in house — generates drafts that reflect SHC’s empathetic and caring tone, and is seamlessly integrated into staff members’ existing workflows. He said all of this aims to improve staff wellness by making it easier for them to do their jobs.
Working closely with revenue cycle partners, SHC launched the pilot in January with 10 billing staff members.
“We saw really high utilization. There was hardly anybody who did not want to use this tool,” Mr. Bhasin said. “And we saw meaningful efficiencies.”
During the pilot, the 10 billing representatives processed thousands of patient billing messages and provided feedback, which was incorporated into the solution, according to SHC. Billing representatives saved about one minute per message, amounting to roughly 17 hours saved during the pilot.
Moving forward, Mr. Bhasin said SHC will continue to assess the program, iterate based on feedback, and monitor utilization and response quality.
“Patients have been happy with the quality and timeliness of the responses — the staff is excited about the capability — and the organization is seeing efficiencies,” he said. “So, it’s been a win-win-win.”
