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Key Takeaways:
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- AI platforms can significantly reduce admin costs for healthcare organizations.
- HR teams can use AI-powered automations to manage intermittent FMLA.
- AI can ensure the right staff-to-patient ratios when employees are on leave.
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In healthcare, administration accounts for 15%-25% of all costs. A lot of healthcare admin time is outward-facing — patient scheduling, billing management, and insurance claims processing, for example. AI for healthcare administration can handle those simple, repetitive tasks, and it can help HR teams with complex internal tasks.
Read on to learn how AI is bringing new efficiency to healthcare administration.
How Is AI Used in Healthcare Administration?
Healthcare organizations are using AI for processes like confirming prior authorizations, verifying billing codes, and even reminding patients about upcoming appointments. Some healthcare organizations are also using AI to simplify the process of managing employee leave, from intermittent FMLA to sabbaticals.
The Aspen Group, a healthcare company with 20,000 employees across all 50 states, had been outsourcing leave management to a TPA, but that provider couldn’t handle the complexity or volume of leave requests. HR leadership decided to bring leave management back in-house, with the support of Pulpstream, a leave management platform that includes AI-powered automations.
Pulpstream enabled the 4-person HR team to oversee leave management with less effort, automating communications and workflows, ensuring compliance, and documenting each step for every case.
How AI Improves Healthcare Leave Management
Front-line healthcare work can be physically and mentally challenging. Burnout, illness, and injuries are common in this field, which can create a high volume of leave requests for HR teams. Managing different types of leave for employees in multiple states creates a lot of admin work for HR teams. Here are some ways AI helps lighten the load:
Intelligent Scheduling
AI can save time for managers and HR teams by suggesting which employees can cover leave-related scheduling gaps, based on their credentials, workload, and availability. AI-powered analytics can also reveal trends like which months are prone to more absences, so managers can prepare in advance for possible staff shortages.
FMLA Fraud Detection
The signs of FMLA fraud are easy to miss when HR teams are overloaded. AI can flag common signs like questionable medical documentation, absence patterns that don’t align with the original leave request, or failure to respond to recertification requests. AI can then notify HR staff when a case requires further investigation.
Data-Based Return-to-Work Plans
AI-powered accommodation management helps healthcare HR teams make informed decisions about RTW plans. For example, Pulpstream AI connects to the Job Accommodation Network (JAN) and medical databases (MDG by ODG) to find and suggest accommodations for employees. Automated documentation of RTW discussions and decisions gives HR teams a compliance-ready record of every case.
Workers’ Comp Case Management
AI can manage cases that simultaneously trigger FMLA and workers’ comp eligibility, determining deadlines, preventing overlapping benefits, and notifying the employee about what documentation is required.
A Better Employee Experience
Employees often feel confused or left in the dark about their employer’s leave management process. AI gives employees clarity — prompting them when action is required or a document is ready to review — and it eliminates lengthy back-and-forth email chains and procedural bottlenecks.
End-to-End Compliance
From the initial leave request to a worker’s return, AI helps HR teams avoid compliance errors. Pulpstream’s platform includes a compliance engine that monitors all federal, jurisdictional, and company leave-related rules and updates in real time when rules change.
How to Get Started With AI for Healthcare Administration
Transitioning from manual leave management processes to an AI-powered software platform can feel intimidating. But you don’t need an internal IT team to take the next step. Pulpstream guides you through the whole process, with white-glove support.
We customize Pulpstream for every customer, so you can be sure our software works the way you want it to and integrates with the technology you want to keep. And customization doesn’t end with onboarding. Should your needs change, let us know, and we’ll work on a solution.
Find out what you can do with Pulpstream. Schedule your walkthrough now.
FAQ
Will AI take over healthcare administration jobs?
AI supports healthcare administrators, but it doesn’t replace them. The benefits AI brings are equivalent to having a larger team, without the additional salary.
How secure is AI for healthcare organizations?
Pulpstream is HIPAA certified, SOC 1 & SOC 2 Type II Certified, and in compliance with GDPR, CCPA, and CPRA, ensuring data is secure.
Will AI work with my other HRIS tools?
Pulpstream natively integrates with Workday, SAP, Rippling, and other HR platforms. We can also build an API to connect any tool to Pulpstream.
