AI Transformation: Turning Previously Unwinnable Cases into Victories
In the ever-evolving world of technology, one company, Allee, is making strides in the field of Artificial Intelligence (AI) to transform denials management and improve denial outcomes.
The strategic focus of Allee lies in denials management, a critical aspect of the financial industry. With AI, they have been able to address a longer tail of accounts that were previously financially unviable. This shift has led to a significant improvement in their time to cash from account placement through payment, with a 40-day improvement recorded.
Allee's approach is rooted in a four-pronged framework: capacity, capabilities, culture, and conviction.
Capacity refers to the ability to sustain real AI solutions over multiple years. The company's capacity has enabled them to consistently see a 10 to 20 percentage point lift in success rate.
Capabilities are about whether an organization already has the in-house expertise to build and scale software. AI has reduced the need for second and third appeals by roughly 20 percent, showcasing Allee's strong capabilities in AI technology.
Culture is a crucial factor in the successful implementation of AI. Leadership at Allee embraces innovation, willing to iterate, fail, learn, and try again. This culture of resilience and adaptability is key to their success.
Conviction is about the time horizon; a five-year commitment is needed to build internally. Allee's conviction in AI technology has been instrumental in their strategic decision-making, whether it's building, buying, or partnering for each use case.
For providers who haven't yet made the leap to AI, denial rates are only increasing, and the technology gap is becoming insurmountable without AI. The question isn't an if or when, but what is your AI strategy?
Allee's strategy is clear: be clear on outcomes and use cases. Their model, historically, has focused on higher-dollar claims with a minimum balance of $10,000. However, with AI, they can now effectively work on DRG downgrades, previously left untouched due to partial denials and lower dollars.
The expected realistic performance metrics for AI technology providers include high accuracy in understanding and interpreting statements, timely and efficient processing speeds, robustness to handle diverse and ambiguous inputs, and reliability in providing consistent and actionable outputs.
In a world where AI is becoming increasingly essential, Allee is setting the pace in denials management, demonstrating that with the right strategy, AI can transform industries and drive success.
