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
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