Todd Doze, CEO of Janus Health, specializes in bringing AI to hospitals to connect the hospital revenue cycle management with the overall patient experience. Automating some manual RCM tasks, such as prior authorizations and referrals, has led to significant reductions in claim denials, faster processing times, fewer errors, and better compliance with recent legislation. Challenges remain to ensure the AI model's accuracy and to demonstrate clear ROI and a direct impact on the hospital's revenue.

Todd explains, "Today at Janus, we focus on helping providers improve their operational and financial efficiency. We work with about 250 acute care hospitals across the country, servicing some of the largest health systems in the nation by providing automations and AI-driven operational intelligence. This gives management insight into what their revenue cycle folks are doing to ensure they're taking the optimal paths to adjudicate claims and also automating as much of the laborious, tedious work that goes into treating patients in the most optimal manner."

"There are a lot of very manual pain points within the rev cycle experience. For example, many of us have been referred by our primary care physician to a specialty provider. A very common example is referring to an imaging center for an MRI or X-ray. And many times, to access an appointment with that specialty provider, the provider may need to submit a prior authorization request to the patient's insurance. And then there's also the communication loop process focused on the referral. And so there are many areas for error, and there are a lot of ways the patient experience can go south very quickly."

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Automating Hospital Revenue Cycle Management with Todd Doze Janus Health TRANSCRIPT