#United States #Towson #VERACITY #PayerWatch #AI-assisted

PayerWatch Introduces AI-Assisted Appeal Drafting

PayerWatch, a notable name in the healthcare technology sector, has unveiled a revolutionary feature aimed at enhancing the efficiency of healthcare providers in managing appeals. This new functionality, integrated into their Veracity™ platform, leverages cutting-edge artificial intelligence to streamline the drafting process of appeals, significantly optimizing the workflow for clinicians.

Accelerated Drafting Process

The newly launched AI-assisted appeal drafting tool is designed to deliver first drafts in approximately three minutes, achieving an impressive accuracy rate of 96% for Emergency Department Level-of-Care (ED LOC) downgrades, as verified by a panel of registered nurses and medical doctors. This level of precision is crucial for healthcare systems looking to minimize denials and ensure proper patient care.

Dr. R. Kendall Smith, Jr., Chief Medical Officer at PayerWatch, emphasized the importance of this feature by stating, "Teams want fewer clicks and stronger first drafts—delivered in the workflows they already use. Veracity's AI assembles the facts and drafts the appeal in minutes. A clinician then verifies the content before submission. It's speed and rigor, grounded in PayerWatch's 20 years of denial-management experience.”

Flexibility and Integration

A standout aspect of the Veracity platform is its EMR-agnostic nature, meaning it can seamlessly integrate into existing workflows without the need for replatforming. This allows healthcare organizations to utilize the AI capabilities without disrupting their current systems. Veracity adapts to various electronic medical records such as Epic, Oracle Health (Cerner), and MEDITECH, ensuring that it fits within the operational frameworks that many providers already employ.

Additionally, the platform offers a flexible operational model to accommodate different organizational needs. The AI can draft first appeals which are then verified by in-house clinicians. Alternatively, organizations may choose a co-review model where the AI drafts the appeal, and a clinical review team conducts quality assurance before submission, or a managed option for more complex cases involving denials, where PayerWatch’s clinical team handles drafting, verification, packaging, and submission.

Future Additions

Coming soon to the Veracity platform are two crucial modules: Clinical Validation and Medical Necessity. These features are set to expand the capabilities of the platform further, maintaining the same human-in-the-loop approach that guarantees accuracy and quality. The new modules will support payer-specific templates, API submissions, and automated secure uploads, ensuring users can easily navigate the complexities of healthcare billing and appeals.

Request a Demo

Currently, the ED LOC drafting feature is live and available for U.S. health systems. Organizations interested in integrating these capabilities can request a demo through PayerWatch’s website to see firsthand how this innovative approach can support their revenue cycle teams.

About PayerWatch

With a strong commitment to helping hospitals prevent denials and efficiently manage those that occur, PayerWatch combines its Veracity software with rich clinical expertise. The company is well-positioned to provide the tools, data, and support necessary to enhance revenue recovery efforts and reduce administrative burdens on healthcare providers. Their vast experience spans over two decades in managing denial appeals across various health systems, providing invaluable insights into effective denial management.

For more information, visit PayerWatch's official site and discover how their AI-assisted solutions can transform your healthcare organization's approach to denial management.