Machine learning helps track health insurance payments

Northside Hospital in Atlanta is adopting machine learning technology to enable the organization to predict when insurance companies will end payments.

The new technology it’s using is from The SSI Group, which is providing technology that aggregates all remittance data coming through its clearinghouse to make the predictions.

The goal is to enable providers that manually build their own spreadsheets to predict payments to use the SSI technology to determine when they can expect to get paid, down to the day and time, according to the vendor.

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“Without predictive analytics, hospitals and other providers are left guessing when they will receive payments,” says Eric Nilsson, chief technology officer at SSI. Using analytics, SSI can give greater visibility on the payment of institutional, professional, in-patient and out-patient claims.

Christopher Richmond, manager of business office services at Northside Hospital, says the new service gives more visibility into information used to drive the business. “Knowing when and how much we will get paid is of the upmost importance,” he adds. “With this tool, we have reduced manual efforts and uncertainty in understanding our cash expectations.

The vendor now is working on expanding predictive analytics to support claim denial rates and audit rates in the future.

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