AGS Well being Introduces Agentic Digital Workforce Options to Sort out Rising Declare Denials and Margin Pressures

Healthcare suppliers are beneath unprecedented pressure from rising declare denials, staffing shortages, and mounting margin pressures. To assist meet these challenges, AGS Well being, a number one supplier of tech-enabled RCM options and a strategic development accomplice to healthcare suppliers throughout the U.S., has launched a brand new suite of agentic digital workforce options powered by AI brokers and clever automation.

“Labor-intensive processes, fragmented RCM ecosystems, and repeatedly shifting payer guidelines have put healthcare finance leaders at a drawback,” mentioned Patrice Wolfe, CEO of AGS Well being. “CFOs at the moment are coping with alarming denial tendencies and vital monetary threats that demand new methods led by a collaborative digital RCM workforce constructed for scalability and engineered for affect. Via agentic AI, AGS Well being empowers healthcare leaders with digital brokers that work alongside their groups, taking up autonomous duties and recommending data-driven subsequent steps to enhance decision-making.”

Market Pressures Driving Pressing Change

Decrease reimbursements and denials are cited by 84% of well being system leaders as the highest drivers of declining margins. With international healthcare RCM software program and providers spending projected to develop from $42.6 billion in 2024 to $65.7 billion by 2031, funding in automation is accelerating. In line with a latest Black Guide Analysis survey, inside the first six months of adopting AI-powered RCM options:

• 83% of organizations noticed declare denials decreased by at the least 10%.
• 68% reported improved internet collections.
• 39% noticed money move improve by greater than 10%.

A New Class of Digital RCM Workforce

“AGS Well being is answering the decision for change with AI brokers that degree the enjoying discipline for overburdened RCM groups,” mentioned Thomas Thatapudi, CIO of AGS Well being. “Our next-generation, AI-infused workforce options convey velocity, agility, accuracy, and human-like decision-making to crucial RCM features resembling eligibility verification, prior authorizations, denials administration, and appeals.”

AGS Well being was just lately acknowledged with a UiPath AI25 Award for its pioneering use of agentic AI to assist healthcare organizations scale back the monetary affect of denials. Its digital workforce options AI brokers that perceive pure language, adapt to altering guidelines and workflows, and make autonomous choices to drive measurable enterprise outcomes, together with fewer denials and better clear declare charges.

Key advantages embrace:

• Monetary: Quicker reimbursement and decrease cost-to-collect
• Operational: Improved workers effectivity and give attention to high-value work
• High quality: Fewer errors in coding, knowledge entry, and appeals

The Hybrid Intelligence Benefit

Whereas AI methods can act autonomously, RCM professionals stay central to a profitable digital workforce mannequin. Expert specialists assist practice and refine the AI, driving technique whereas sustaining oversight and accountability.

“Our hybrid intelligence mannequin combines AI’s velocity, accuracy, and scalability with human experience and empathy,” added Thatapudi. “AI brokers handle high-volume duties whereas professionals deal with exceptions and information steady enchancment. This may be achieved in-house domestically or by means of our globally distributed workforce mannequin to cut back working prices and permit for twenty-four/7 manufacturing schedules.”

By making ready work, surfacing insights, and managing exceptions, AGS Well being’s AI brokers empower RCM groups to make smarter, quicker choices with out compromising high quality.

For extra data on AI brokers and digital workforce options from AGS Well being, go to https://www.agshealth.com/ai-platform/ai-agents-and-intelligent-automation/.