PITTSBURGH, March 21, 2023 – PNC Treasury Management today announced the availability of PNC Claim Predictor, a new artificial intelligence and machine learning solution that helps healthcare organizations proactively identify inaccurate or undercompleted insurance claims prior to submission.
The process of filing insurance claims has been a challenge for healthcare organizations for years and has resulted in lost revenue, extended deadlines and the diversion of critical resources. On average, insurers initially reject nearly $5 million per provider1 in claims, resulting in either lost or compromised revenue for healthcare organizations. Additionally, it costs nearly $100 per application to revise and resubmit applications2, so it is not surprising that 45% of rejected applications are never resubmitted3.
“We saw that our healthcare customers could benefit from an efficient way to address the challenges they continue to face when filing claims, and that is precisely why we created PNC Claim Predictor to help them address the challenges problems,” said Doug McKinley, senior vice president and head of innovation for PNC Treasury Management. “We are committed to constantly developing new and innovative offerings through our treasury management platform to create flexible, secure, seamless and customizable solutions that help our clients run their businesses more effectively and meet the needs of their own clients .”
Leveraging machine learning technology, PNC Claim Predictor uses historical data from submitted claims, allowing it to “learn” the claim attributes and associated patterns from organizations – allowing the solution to predict which future claims are likely to be rejected and what type of information Healthcare organizations need to obtain so they can correct claims prior to filing. The ultimate goal is to save healthcare organizations time and money and avoid lost revenue. An additional feature of the new solution is that it can be integrated with the existing electronic medical record system of an organization like Epic. So there is no need to switch between systems or have separate logins, dashboards, etc. PNC Claim Predictor offers a seamless user experience.
For more than 25 years, PNC has been focused on serving the healthcare industry to help providers and payers achieve their business and service goals. This claims solution is a continuation of that work as the bank seeks to provide fully integrated solutions and strategic services to maximize working capital, streamline revenue cycle processes, mitigate risk and access capital. PNC serves a broad spectrum of healthcare customers with their financial needs, including for-profit and not-for-profit acute care systems, physician groups, billing companies, laboratories, home care companies, home health care, extended care, healthcare payers, and corporate purchasing organizations.
PNC Treasury Management provides a platform of innovative end-to-end technologies and experienced teams to help clients design and implement a cohesive cash management system for their business. PNC is committed to investing in leading technology and will continue to help clients optimize working capital; Achieve faster and safer transactions; and drive their business forward.
PNC Bank, National Association, is a member of PNC Financial Services Group, Inc. (NYSE: PNC). PNC is one of the largest diversified financial services institutions in the United States, organized around its clients and communities to ensure strong relationships and local delivery of personal and commercial banking, including a full line of credit products. specialized business and government services, including corporate banking, real estate financing and asset-based lending; Wealth Management and Wealth Management. For more information on PNC, visit www.pnc.com.
1 LaPointe, J., “$262 billion in total hospital bills in 2016, initially denied claims,” RevCycleIntelligence, 2017.
2 “The best denial recovery strategy is prevention,” Becker’s Hospital Review, 2019; “Overcoming the Top Challenges in Claim Denial Management Audits,” Revenue Cycle Intelligence, 2018; “262 billion in health insurance claims initially rejected in 2016,” Change Healthcare, 2017.
3 “You Can Be Losing Thousands of Dollars a Month to “Unclean” Claims,” Medical Group Management Association, 2014.