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AI Adoption in Healthcare is Growing. Healthcare Pros Need To Differentiate Between AI, Automation, and Unfounded Hype.

According to a recent survey from healthcare advisory firm Sage Growth Partners, a staggering 90% of hospitals now have the power of artificial intelligence on their radar, in varying stages of adoption, to revolutionize patient care and streamline operations. AI adoption in healthcare organizations is poised to achieve better, more equitable, and affordable patient outcomes….

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According to a recent survey from healthcare advisory firm Sage Growth Partners, a staggering 90% of hospitals now have the power of artificial intelligence on their radar, in varying stages of adoption, to revolutionize patient care and streamline operations. AI adoption in healthcare organizations is poised to achieve better, more equitable, and affordable patient outcomes. For example, machine learning in medical diagnostics has already shown significant potential to improve the accuracy and efficiency of diagnoses.

Healthcare has increasingly become the ultimate proving ground for AI technology, with applications ranging from predictive analytics to personalized medicine. Experts believe that AI and ML can revolutionize the industry by identifying patterns in complex data, automating repetitive tasks, and enabling more informed decision-making. It’s becoming more and more evident, though, that this technology ecosystem can come with a lot of hype, and that hype can cloud important judgment and understandings around different tech in the artificial intelligence ecosystem. Christina Cussimanio, SVP of Marketing at AGS Health, highlights the growing role of AI adoption in healthcare organizations, emphasizing the distinction between AI and automation while illustrating AI’s potential to transform revenue cycle management.

Christina’s Thoughts

“Did you know more than 80% of healthcare organizations report they’ve already implemented an AI strategy? AI is addressing some of healthcare organizations’ biggest pain points, increasing revenue capture, and helping those early adopters achieve revenue integrity. With that being said, AI and automation are terms that are often used interchangeably.

However, the differences are not as subtle as they appear. While automation’s about setting up bots to follow a set of predefined rules, AI is about setting up cognitive bots to make their own decisions. AI is made up of different technologies that allow the machine to act at the human level of intelligence, a process that requires learning from past experiences and self-correction to make decisions and reach conclusions. A good example of AI is the ability to predict denials by identifying and assessing attributes commonly found in at-risk claims before or prior to submission. You can learn more about the role of AI in RCM operations by reading our white paper, artificial intelligence for RCM, separating hype from reality.”

Article Written by Azam Saghir.

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More Healthcare Insights

Denials get a queue, underpayments just look like paid claims

Denials get a queue, underpayments just look like paid claims

Underpayments in healthcare revenue cycle operations lack the visibility of denied claims because they don't trigger alerts or queue workflows. Without dedicated ownership and line-level verification against contract terms, paid claims that fall short of their contractual amount pass through undetected.

  • 01Denial workflows activate on rejection events, but underpayments produce no event, leaving paid claims unverified by default.
  • 02The speaker says many provider groups lack line-level contract intelligence to check each paid line against the applicable terms.
  • 03Payment received and payment checked are separate tasks: one verifies acceptance, the other verifies correctness—and the second often has no assigned owner.

Nov 6, 2026

A zero-paid claim line is not automatically an underpayment

A zero-paid claim line is not automatically an underpayment

A zero payment on a claim line isn't automatically an underpayment; contract terms, particularly packaging rules, determine whether zero is correct. Chasing unsupported findings damages credibility with payers and weakens the position of legitimate disputes, so revenue cycle teams must verify the full contract terms and effective dates before treating any payment difference as a finding.

  • 01When a contract packages add-ons into the primary procedure, the add-on line may legitimately show zero payment because it is folded into the primary procedure reimbursement.
  • 02Pursuing payment differences that lack contract support burns credibility with payers and can weaken the team’s position on later disputes, including valid ones.
  • 03Always verify the complete contract terms, fee schedules, carve-outs, amendments, and the specific version in effect on the date of service before treating a payment variance as a recoverable underpayment.

Nov 6, 2026

A clean, paid, closed claim can still be short of the contract

A clean, paid, closed claim can still be short of the contract

Practices can receive payment on closed, clean claims that still fall short of negotiated contract amounts because billing ends at coding, submission and posting, while no role owns checking whether payer payments match fee schedules. The speaker argues that contract-level payment review is a separate, complementary function that compares closed claims to contract terms and, run continuously, helps surface shortfalls in time to act within timely filing windows.

  • 01Correctly coded and billed healthcare claims can still result in underpayment.
  • 02Practices should review closed-claim payments against contract terms to spot underpayments.
  • 03Discrepancies in claim payments can persist despite adherence to billing protocols.

Nov 6, 2026

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