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

Healthcare suppliers are below 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 constantly shifting payer guidelines have put healthcare finance leaders at a drawback,” mentioned Patrice Wolfe, CEO of AGS Well being. “CFOs are actually coping with alarming denial traits and important monetary threats that demand new methods led by a collaborative digital RCM workforce constructed for scalability and engineered for impression. Via agentic AI, AGS Well being empowers healthcare leaders with digital brokers that work alongside their groups, taking over 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 keeping with a latest Black E-book Analysis survey, inside the first six months of adopting AI-powered RCM options:

• 83% of organizations noticed declare denials diminished by at the least 10%.
• 68% reported improved web collections.
• 39% noticed money circulate 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 taking part in 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 essential RCM features corresponding to eligibility verification, prior authorizations, denials administration, and appeals.”

AGS Well being was not too long ago acknowledged with a UiPath AI25 Award for its pioneering use of agentic AI to assist healthcare organizations scale back the monetary impression of denials. Its digital workforce options AI brokers that perceive pure language, adapt to altering guidelines and workflows, and make autonomous selections to drive measurable enterprise outcomes, together with fewer denials and better clear declare charges.

Key advantages embody:

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

The Hybrid Intelligence Benefit

Whereas AI programs can act autonomously, RCM professionals stay central to a profitable digital workforce mannequin. Expert specialists assist prepare 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 way of our globally distributed workforce mannequin to scale 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 selections 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/.