Utilization review teams face a constant squeeze: manual HER searches for clinical documentation slow admission and appeal processes, introduce errors and raise denial risk – all while revenue hangs in the balance.
Stormont Vail Health confronted these inefficiencies directly. By adding AI and automation to its utilization review workflow – including automated generation of appeal letters – the team sharpened claim accuracy, reduced chart review time and lifted staff productivity.
The result: earlier identification of admission needs, cleaner documentation for continued stays and stronger protection against denials. In this on-demand session, three Stormont Vail Health leaders walk through what they built, how they implemented it and what changed for their team and their bottom line.
Attendees will learn:
- How AI supports timely admission, denial management and appeal decisions,
- The impact of automation on claim accuracy, denial prevention and resolution,
- How early recognition and prioritization improve patient outcomes and financial performance, and
- Practical lessons from a utilization review team that rebuilt its process.