CommonSpirit Revenue Cycle Leader Outlines AI Guardrails for Denials Management
CommonSpirit Health's system lead for denials management, Deborah Greer, MD, discussed how the health system is implementing artificial intelligence in denials and appeals processes while maintaining physician oversight. Greer emphasized that physician decision-making authority must remain central even as AI tools are deployed by both hospitals and health plans to speed review and denial processes. The article addresses how major health systems are navigating the operational and clinical implications of AI-driven prior authorization and denials management. No specific policy changes or effective dates are identified.
Medicaid managed care organizations and providers are both deploying AI for utilization management and denials, raising operational questions about clinical oversight, appeal timelines, and the adequacy of physician involvement in coverage determinations.
Managed Care
You might also like