What You Should Know:
– AGS Health®, a strategic growth partner and leading provider of tech-enabled RCM solutions, today announced the introduction of a new suite of agentic digital workforce solutions.
– Powered by AI agents and intelligent automation, these solutions are designed to help healthcare providers navigate the unprecedented strain caused by rising claim denials, severe staffing shortages, and mounting financial pressures.
Market Pressures Driving Urgent Change
The current healthcare environment poses significant financial threats to health systems. Rising claim denials and lower reimbursements are cited by 84% of health system leaders as the top drivers of declining margins. This crisis is accelerating investment in automation, with global healthcare RCM software and services spending projected to grow from $42.6 billion in 2024 to $65.7 billion by 2031.
Patrice Wolfe, CEO of AGS Health, emphasized the critical need for a new strategy: “Labor-intensive processes, fragmented RCM ecosystems, and continuously shifting payer rules have put healthcare finance leaders at a disadvantage. CFOs are now dealing with alarming denial trends and significant financial threats that demand new strategies led by a collaborative digital RCM workforce built for scalability and engineered for impact.”.
The success of early AI adoption in RCM is already evident, with a recent Black Book Research survey reporting that within the first six months of adoption:
- 83% of organizations saw claim denials reduced by at least 10%.
- 68% reported improved net collections.
- 39% saw cash flow increase by more than 10%.
A New Class of Digital RCM Workforce
AGS Health’s new solutions utilize next-generation, AI-infused workforce solutions to bring speed, agility, and accuracy to critical RCM functions. These AI agents are built to address core pain points such as eligibility verification, prior authorizations, denials management, and appeals.
The key benefits derived from this digital RCM workforce include:
- Financial: Faster reimbursement and lower cost-to-collect.
- Operational: Improved staff efficiency and focus on high-value work.
- Quality: Fewer errors in coding, data entry, and appeals.
The Hybrid Intelligence Advantage
The company stresses a hybrid intelligence model where human RCM professionals remain central to strategy, oversight, and accountability. Skilled specialists help train and refine the AI, guiding continuous improvement.
“Our hybrid intelligence model combines AI’s speed, accuracy, and scalability with human expertise and empathy,” said Thomas Thatapudi, CIO of AGS Health. AI agents manage high-volume tasks autonomously, while human professionals handle exceptions and strategic direction. This flexible approach can be deployed domestically in-house or through AGS Health’s globally distributed workforce model to reduce operating costs and allow for 24/7 production schedules.
