Penny automates routine tasks, surfaces data, and assists your operations with complex tasks, helping you optimize workflows and improve cash flow.
Draft for Utilization Review
AI saves utilization managers time by reviewing data across the chart to justify why the patient belonged in the hospital.
Draft for Utilization Review
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Draft Denial Appeal Letters for Professional Billing Denials
AI drafts appeal letters and supporting clinical summaries for denied professional billing claims by extracting relevant clinical documentation from patient charts.
Draft Denial Appeal Letters for Professional Billing Denials
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Identify Clinical Risk Adjustments
Improve risk capture, chronic disease management, and diagnosis coding accuracy to neither overstate nor understate a patient’s clinical risk using data from the patient's chart.
Identify Clinical Risk Adjustments
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Build Pages for your Campaigns, Education, Studies, or Services
Marketing and clinical teams can launch comprehensive patient education microsites faster using generative AI tools to quickly create drafts of patient-facing MyChart microsites that promote specific services and outreach initiatives.
Build Pages for your Campaigns, Education, Studies, or Services
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Coding Assistants
AI-generated coding suggestions give professional billing and hospital coders a head start, speeding up the process and making it easier to select the correct code.
Coding Assistants
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Draft Denial Appeal Letters for Denied Outpatient Claims
AI can quickly process large amounts of clinical information and draft a persuasive appeal reason so denial specialists have a solid starting point for their appeal packet.
Draft Denial Appeal Letters for Denied Outpatient Claims
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Summarize Information for Prior Authorizations & Medical Necessity
Authorization users can use AI to search for the documents they need to respond to requests and build a proposed response.
Summarize Information for Prior Authorizations & Medical Necessity
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Answer Prior Authorization Questions
To save time filling in electronic prior authorizations, the system drafts answers for prior authorization questions using structured and unstructured clinical documentation.
Answer Prior Authorization Questions
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Analyze Dashboard for Key Takeaways
AI tools can summarize reporting content, suggest possible conclusions, and identify key insights, outliers, anomalies, and patterns so you can act on metrics quickly.
Analyze Dashboard for Key Takeaways
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Draft Denial Appeal Letters for Inpatient Accounts
Automatically create an appeal letter that includes the AI-generated basis for appeal and the clinical documentation, saving staff time.
Draft Denial Appeal Letters for Inpatient Accounts
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Transform Questions into Reporting Queries
Save time by asking questions in plain language and letting AI build queries based on your questions.
Transform Questions into Reporting Queries
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Review Payer Guidelines and Policies in Epic
Load payer guideline documents into Epic so denials specialists can review them when appealing outpatient denials and use AI to determine whether the procedure meets medical necessity requirements and incorporate information from the documents into the appeal letter.
Review Payer Guidelines and Policies in Epic
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Ensure Surgical Procedures Match the Surgeon's Request
Schedulers can use AI-generated suggestions to identify missing or incorrect procedures in case requests, helping ensure accurate procedure selection and reducing downstream issues with resource planning and reporting.
Ensure Surgical Procedures Match the Surgeon's Request
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Review Documentation Improvement Suggestions
The system evaluates the patient's clinical documentation and identifies query opportunities to improve the documentation's quality, along with justification for each suggested query.
Review Documentation Improvement Suggestions
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Populate Patient and Document Type from Scans
Reduce the amount of human attention required to retrieve information from documents using AI to identify which patient a scanned document is for and what type of document it is.
Populate Patient and Document Type from Scans
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Draft Outreach Campaigns
With AI-generated outreach drafts, you can speed up the creation of new campaigns by queuing up language to send to patients and prospects so users are less dependent on the marketing team for strategy and content.
Draft Outreach Campaigns
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Evaluate Patients for Clinical Trials
Study team members can determine whether patients are a good fit for a study using AI-generated analysis. It gathers patient information and compares it to a study’s eligibility criteria and exclusion criteria.
Evaluate Patients for Clinical Trials
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Alert Staff and Manage Patient Flow
Patient flow expediters can reroute patients from areas at or over capacity to appropriate areas with space to care for the patient with help from AI, so obstacles are addressed proactively without constant manual monitoring.
Alert Staff and Manage Patient Flow
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Discharge Planning Insights from Clinical Notes
AI surfaces information for care team members to consider as part of daily rounding conversations based on existing documentation throughout a patient's chart and suggests follow-up actions, proposes expected discharge information and delays, and applies or completes discharge milestones for patients.
Discharge Planning Insights from Clinical Notes
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Evaluate Medical Necessity Against Health Plan Criteria
AI suggests which of the medical necessity criteria are met for the policy and shows supporting clinical evidence, so UM staff don’t need to search through the chart for relevant data as often.
Evaluate Medical Necessity Against Health Plan Criteria
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Extract Clinical Policies from Health Plan Documents
Help utilization management staff complete authorization review by showing discrete medical necessity criteria right alongside clinical data they need to compare those criteria against.
Extract Clinical Policies from Health Plan Documents
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Highlight Key Information Related to Potential Diagnoses
AI helps to surface relevant clinical evidence from notes so that coders don’t need to gather this information manually.
Highlight Key Information Related to Potential Diagnoses
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Assist with Health Plan Authorization Decisions
The system uses AI to match the diagnosis and requested procedure of an authorization against clinical notes and documents to surface the most relevant information.
Assist with Health Plan Authorization Decisions
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Using the Post-Visit Risk Adjustment Coding Assistant
↓44%
processing time for general surgery
↓49%
denial rate for charges reviewed with the model
Less Digging, Faster Answers: How AI-Drafted Responses Are Streamlining Specialty Pharmacy Prior Authorization
Advocate Health replaced phone and fax with digital workflows for communication with payers about specialty medication prior authorization, helping it submit requests an average of one full day sooner. It also started using AI-generated draft responses to payer requests for more information, cutting pharmacy staff’s time from up to 25 minutes to just 5 minutes per authorization.
Reimagining Nursing with Generative AI: A Culture of Care and Innovation
On the first day live, 75% of potential patient end-of-shift care plan notes were AI-generated. After two months, that number has jumped to more than 90% across Mercy’s 50 hospitals. Compared to baseline care plan notes filed last year, we’ve had a 225% improvement in shift care plan documentation.
Empowering Clinicians with AI: Why Thoughtful Governance Matters
We want to put new solutions out there only if they are going to make the lives of clinicians and patients better. We considered how we could make the adoption of generative AI as frictionless as possible, and we adopted a “go slow to go fast” mentality: we are thoughtful in how we evaluate and implement AI solutions so the solutions that we do roll out have an immediate, positive effect on our clinicians and our patients.
Generative AI Is Moving Fast. Here’s How We’re Keeping Up.
"Today, we’re in the 97th percentile across the Epic community for our use of In Basket Art in outpatient settings. Our clinicians are using AI-generated chart summaries to help them prepare for outpatient visits over 90% of the time. More than one-third of accounts with professional charges coded included AI-suggested charges that might have otherwise been missed. The positive feedback we’re hearing from our clinicians using ambient voice recognition, note summaries, AI-drafted hospital course notes, text assistant, and other features is proof of what’s possible when leadership doesn't just put new features out there, but actively champions them."
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