By Curt Neel, President/Operating Partner, Triton Healthcare Partners
An automated workflow is paramount when it comes to developing unique processes and meeting clients’ needs. Technology-based solutions are becoming the cornerstone of adaptive and efficient next-generation processing models. While the importance of automation cannot be understated, the next logical steppingstone is AI-assisted decision-making.
Artificial Intelligence, or AI, is a technology that is transforming businesses across every industry and all walks of life, including Finance, National Security, Criminal Justice, Transportation, and Healthcare. This growing form of technology can help companies reimagine how they analyze data, gather information, and develop processing solutions that were not previously considered or even possible.
There are various definitions of Artificial Intelligence, and there is no uniformly agreed-upon meaning since it is used in different ways for different purposes. Most at least agree that Artificial Intelligence, in its most basic form, is machine-assisted decision-making. While some may imagine AI as a sentient robot, in its simplest form, Artificial Intelligence can be broken down into a series of algorithms that are designed to “make decisions” using data, in real time. These algorithms can combine information from a variety of different sources, then analyze the data and act on that information according to the algorithms in place. Thanks to improvements in storage systems and processing speeds, algorithmic-based decision-making has improved greatly in recent years.
The idea of AI-based solutions was once a futuristic concept for applicable business use. However, today the use of AI and algorithmic-based processing solutions are already being integrated into claims and managed care applications. This next generation AI technology allows the claims industry to customize managed service models, specifically to their clients’ claims population needs. As a result, clients get tailored programs that more effectively address the claims and managed care service demands/requirements.
While the world continues to develop and deploy AI, there are already significant insights that can be used for performance enhancements. Information related to claims experience, provider data analytics, outcomes and expense, can be utilized to improve care management results.
About Curt Neel
Curt has 30 years of experience in insurance, health plan management, network contracting, and operations. As Triton Healthcare Partners’ Operating Partner, Curt is responsible for business operations and works closely with Rich Pappa, whose CloudWorx team has designed and managed Triton Healthcare Partners’ database and network optimization platforms. Rich has worked with Mike Lindberg, Triton’s Founding Partner, for over 25 years in the managed care industry.
About Triton Healthcare Partners
Triton Healthcare Partners has over a million providers in all 50 states, providing a national, customized network solution for its clients. Triton provides a total network solution or can be an alternative to enhance existing strategic partnerships.
We offer national network optimization, working on our clients’ behalf to create a traditional network solution, specialty wrap network service, or customized payment service model.
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This is NOT a paid placement.