Artificial Intelligence: Build relationships with payers

Q. I’m implementing AI solutions in my DME business - how can this improve relationships with payers? 

A. Credibility is the foundation of the partnership between your DME business and payers. AI-driven solutions reinforce this and build trust by reducing errors and ensuring smoother communication. 
 
On the intake side, AI enhances this trust by detecting errors before submission - this significantly reduces denied claims, which are burdensome on both your team and the payer. By validating documentation against payer guidelines before submission, you ensure claims are clean and complete, resulting in faster processing for both parties. Of course, this also improves your business’s cash flow. 
 
AI tools can enhance communication. The largest payers embrace the use of AI Voice Agents, facilitating navigation of their IVR systems and streamlining interactions with their representatives. These Agents are fully capable of handling both routine and complex payer inquiries. These solutions produce more effective communication by reducing the burden of back-and-forth emails and lengthy phone calls. AI solutions enable your team to spend less time waiting on hold and chasing information, and more time focusing on delivering quality service. 
 
Audits are inevitable. When they occur, AI-powered tools will have already generated and documented the required validation evidence at the time of service, giving you everything you need to file your appeal. This saves time and demonstrates your commitment to transparency and accuracy. Additionally, AI tools can monitor regulatory changes, helping your business stay ahead of compliance requirements and avoid costly penalties. 
 
Integrating AI into your DME operations creates a more reliable, efficient, and compliant business model. This not only fosters stronger relationships with payers but also positions your company as a trusted, forward-thinking partner in the healthcare ecosystem. 

For more information, contact Teresa Power, director of marketing at Synthpop, at teresa@synthpop.ai.