At many health systems, utilization review and revenue capture operate separately. Clinical teams make care decisions, and financial outcomes follow later, often with denials, missed inpatient revenue and rework.
A growing number of utilization management leaders are changing that. By incorporating AI and predictive analytics into utilization review and physician advisor workflows, both clinical and financial teams have a shared, real-time view. The outcomes they report include stronger inpatient revenue capture, improved denial management and staff efficiency gains.
This session offers a candid look at connecting clinical decisions with appropriate revenue capture while offering effective strategies for change management.
What you'll learn:
- How AI and predictive analytics streamline utilization review and physician advisor workflows.
- Where clinical-financial alignment strengthens inpatient revenue and denial management.
- The change management practices that drive staff adoption.
- How to keep clinical judgment central as AI supports decision-making.