Defense Strategies Against AI Audits

Monitor Mondays

Artificial Intelligence (AI) software is now in the “hype phase” of adoption.

It promises to increase the efficiency of medical audits. But also, AI is being touted as being able to handle much more data, examine many more cases, and instantly make decisions regarding medical necessity or inadequate documentation.

The number of audits can be doubled, tripled, quadrupled. Why take samples for review when AI can audit every single claim submitted? Providers can expect a deluge of demands for recoupment, all delivered with exquisite and compelling prose.

But is AI as accurate or as thorough or efficient as promised? During the next live edition of Monitor Mondays, RACmonitor investigative reporter Edward M. Roche will review basic defense strategies that providers can deploy against such audits, and look into the future to uncover some of the problems on the horizon.
Broadcast segments will also include these instantly recognizable features:

• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.

• The RAC Report: Healthcare attorney Bart Daniels, partner at the law firm of Nelson Mullins, will report the latest news about auditors.

• Legislative Update: Cate Brantley, senior government affairs liaisons for Zelis, will report on current healthcare legislation.

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.