Change Healthcare Unveils Claims Lifecycle Artificial Intelligence

Claims Lifecycle Artificial Intelligence is a new capability that
integrates artificial intelligence across the Change Healthcare network,
solutions, and services to help providers and payers realize new
efficiencies

ORLANDO, Fla.–(BUSINESS WIRE)–lt;a href=”https://twitter.com/hashtag/AI?src=hash” target=”_blank”gt;#AIlt;/agt;–HIMSS19 Booth 3679—Change Healthcare today announced Claims
Lifecycle Artificial Intelligence, a new capability being integrated
into the company’s Intelligent Healthcare NetworkTM and
financial solutions, to help providers and payers optimize the entire
claims processing lifecycle.


This Change Healthcare Claims Lifecycle AI service is trained on more
than 500 million service lines making up over 205 million unique claims
that touch $268 billion in charges. The service leverages the company’s
Intelligent Healthcare Network data from more than 2,200 payers, 5,500
hospitals/health systems, and across 900,000 physicians. Solutions and
services across the Change Healthcare portfolio are using artificial
intelligence (AI) to help customers with improving payment accuracy,
reducing denials, enhancing payment forecasting, and reducing
administrative overhead.

“Our strategy is to bring AI capabilities to the entire healthcare
financial and administrative ecosystem, and claims lifecycle management
is the logical place to start,” said Nick Giannasi, Ph.D., chief AI
officer, Change Healthcare. “We’re using AI to bend the cost/quality
curve of healthcare. By applying AI to our Intelligent Healthcare
Network data, combined with our pervasive presence in payer and provider
workflows, we are delivering new health IT solutions that help customers
address the financial pressures from healthcare costs in ways not
previously possible. Applying AI will transform the claims lifecycle
process.”

The first three customer applications enhanced by Claims Lifecycle
Artificial Intelligence are Change Healthcare’s Assurance Reimbursement
Management™, Revenue Performance Advisor and Medical Network Solutions.
The AI embedded in these applications helps customers predict
denials, optimize claims submissions, and provide actionable
recommendations that enable providers to better mitigate denials prior
to claim submission. Additionally, customers using the Change Healthcare
Intelligent Healthcare Network will be able to access selected AI
capabilities via the Change Healthcare API Marketplace.

From 2018 data, Change Healthcare observed that 23% of claims across
more than 500 million service lines were denied—accounting for over $62
billion in charges. With the Claims Lifecycle Artificial Intelligence
capability, 35% of these denials can be identified and flagged prior to
submission—representing $6.2 billion in forecasted allowed amounts and
millions in potential administrative savings for the U.S. healthcare
system from reduced re-work and appeals.

This initiative is backed by Change Healthcare’s team of data
scientists, adoption of open source technology, and investments in the
cloud. AWS provides the secure, scalable, and agile infrastructure to
enable feature engineering, training of deep learning models, and
delivery through an API. By using AWS Lambda, which integrates Claims
Lifecycle Artificial Intelligence with network applications, and Amazon
SageMaker, to decrease the development time to build, train, and deploy
deep learning models, the Change Healthcare team was able to create the
solution in a rapid and iterative fashion.

The application of AI across the Change Healthcare portfolio of
solutions ushers in a new era of claims processing that benefits key
stakeholders. For providers, it can help reduce unnecessary processing
rework by assessing whether claims were completed accurately, predict
expected payment, and how much will be remitted. Artificial intelligence
can also help empower denial management programs by predicting claim
completeness, denial probability, timing and amount paid, and flagging
missing data.

For payers, Change Healthcare’s expanded AI capabilities analyze
incoming claims to flag missing or incorrect diagnosis codes and help
lower the administrative burden by predicting claim outcomes early,
thereby reducing overhead, increasing savings by identifying errors, and
optimizing workflows. AI can also help payers analyze claims data to
better understand cross-industry appropriateness of care and address
pre-authorization to reduce claim denials. Ultimately, this AI
capability can help payers and providers ensure the accuracy of claims
to make and get the right payment at the right time for the right
service.

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About Change Healthcare

Change Healthcare is inspiring a better healthcare system. Working
alongside our customers and partners, we leverage our software and
analytics, network solutions, and technology-enabled services to enable
better patient care, choice, and outcomes at scale. As a key catalyst of
a value-based healthcare system, we are accelerating the journey toward
improved lives and healthier communities. Learn more at changehealthcare.com.

Contacts

Media contact:
Change Healthcare
Kerry Kelly
External
Communications
339-236-2756
kerry.kelly@changehealthcare.com