Baptist Health is leading the AI charge to reduce costs, streamline operations, and improve patient care and satisfaction.
In the fast-paced world of healthcare, the adoption of artificial intelligence (AI) is no longer just a futuristic dream—it’s quickly becoming a key driver of operational efficiency.
Baptist Health, a Jacksonville, Florida-based health system, is at the forefront of this AI revolution, particularly in the realm of revenue cycle management. Leading the charge is Steven Kos, MSHCS, CHCIO, senior director of revenue cycle application support and a HealthLeaders’ AI in Finance Mastermind participant.
Under his guidance, Baptist Health has been able to leverage AI across multiple areas of the revenue cycle, leading to reduced administrative burdens, increased efficiency, and improved patient satisfaction.
“We primarily use AI in the front office space,” says Kos. “For example, we use it for prior authorization and reducing the administrative burden around retaining that authorization. It has made a significant difference in ensuring that the right coverage is in place for treatments and services.” Kos emphasizes that AI has streamlined tasks that were previously time-consuming and prone to human error.
AI’s Role in Improving Patient Scheduling and Reducing No-Shows
One area where Baptist Health has effectively implemented AI is in ambulatory scheduling. Kos explains that the health system has undertaken a major project to standardize and automate scheduling templates, which is crucial to automating these processes.
“It’s hard to automate something that’s not standardized. Once we standardized our templates, we are now able to automate around them. Centralization of process not only helps manual workflows but also provides capabilities for tools like OCR to be leveraged with AI, which we have done in ambulatory by automatically indexing documentation that is scanned into the medical record,” he says.
A notable use of AI in patient scheduling is predicting the likelihood of no-shows. Using rules-based tools like Fastpass with AI, Baptist Health can forecast the probability of a patient missing an appointment and fill a cancelation. “If we know a patient may be a no-show, we can reach out to the patient, confirm appoint cancelation and offer that spot to someone else,” Kos explains. This proactive approach not only maximizes appointment slots but also improves access to care for other patients.
Kos further highlights AI’s integration into OR scheduling, which has made a considerable impact. “We’re automating case scheduling and improving the access to care by reducing the time it takes to schedule an appointment and render that service,” he adds.
Enhancing Patient Experience with AI in the Contact Center
Beyond the administrative and clinical realms, Baptist Health has also deployed AI in its contact center to enhance patient experience.
According to Kos, conversational AI bots are being used to assist patients in navigating their healthcare journeys. “These bots help patients find where to go, whether it’s finding a physician or determining the most suitable provider for their care. It serves as a virtual assistant, improving patient experience significantly,” says Kos.
These AI tools can handle a range of tasks, including wayfinding and managing referrals. Baptist Health's AI-driven system can process faxed referrals, digitize them, and compare the information against the EHR to ensure that necessary orders are in place and create a referral shell to schedule against.
"We’ve seen good success with this, and as we roll out more solutions in the referral space, we anticipate saving time up to an equivalent of 10 full-time employees," Kos notes.
AI's Expanding Role in Clinical Documentation and Claims
Baptist Health is also exploring AI’s potential in clinical documentation and coding, albeit in pilot phases. The health system is employing ambient and generative AI to capture patient-physician conversations in real-time and generate clinical documentation; starting with small pilots.
“This reduces the documentation burden on physicians, allowing them to focus more on patient care,” Kos says. This technology has already shown promise in improving the accuracy of clinical documentation, which is crucial for supporting the revenue cycle.
In the claims submission and billing arena, AI is helping Baptist Health reduce manual intervention. “We use AI for tasks like claims attachment automation, billing, and coding. AI helps us rank claims based on their priority, so we’re not checking on claims unnecessarily,” Kos explains.
The result is a more efficient claims process, reducing the number of follow-ups and improving overall cash flow.
The Challenges of AI Implementation
While AI offers enormous potential, implementing it comes with its own set of challenges. Kos cautions against the tendency for vendors to “overpromise and underdeliver.” “Vendors can sometimes assume that successful implementations at other healthcare systems will be replicated at your healthcare system. There are a lot of factors to consider.”
“There’s often a lot of legwork on the provider’s part to get things working smoothly. It takes time to tune AI models, and they can sometimes be inconsistent at first,” he says.
Another significant challenge Baptist Health has faced is maintaining trust in AI systems. “If clinicians see that AI isn’t perfect, they lose trust, and adoption slows down,” Kos explains.
Additionally, external factors, such as system upgrades or security changes, can destabilize AI solutions, creating disruptions in automation and undermining confidence in the technology. “Unplugging an underperforming AI system can be worse than living with it, so you must weigh the pros and cons carefully. It is always good to think about what an off- ramp looks like,” Kos advises.
AI’s Potential in Coding and Denials Management
Baptist Health is cautiously optimistic about expanding AI’s role in coding, particularly for simple visit coding. "We already use auto-suggested coding, and we’re piloting further AI integration into the coding process," says Kos.
By incorporating AI earlier in the process, Baptist Health hopes to reduce the number of documentation queries sent to physicians, which would further streamline operations.
However, Kos acknowledges that AI in coding is still a work in progress, particularly for more complex areas like oncology. “Coding in certain specialties requires extreme precision, and AI takes time to learn those nuances,” he says.
The ultimate goal is to reduce denial rates by improving documentation and coding accuracy. Although it’s still too early to quantify the exact impact, Kos is confident that AI will play a pivotal role in reducing payer-related issues.
Repurposing Staff and Enhancing Patient Care
One of the benefits Baptist Health has seen from its AI initiatives is the ability to repurpose staff, particularly in administrative roles to support patient experience.
“When you implement an AI solution, you can often repurpose staff to focus on patient care and customer service. We’re training our staff to become patient advocates, guiding patients through their care and ensuring they get that ‘white glove’ treatment whenever possible,” Kos explains.
Baptist Health is also fostering a culture of continuous learning, encouraging its staff to develop new skill sets around AI and automation.
“We’re training individuals to take on roles that are more supportive of technology, helping to improve workflows and even becoming part of the solution,” Kos says. This focus on upskilling has created opportunities for staff to advance their careers while also improving operational efficiency.
The Importance of Governance in AI Implementation
As AI becomes more integrated into Baptist Health’s operations, the organization has established an “AI Institute” to ensure that new solutions are thoroughly vetted.
“It starts with a business case, then we dive into the details around the AI—how it will work with our environment, the risks involved, and what metrics we’ll track,” Kos explains.
This governance process has been crucial in ensuring that AI investments are aligned with Baptist Health’s broader goals and that resources are allocated effectively.
Looking Ahead
For Baptist Health, AI is more than just a technological innovation—it’s a transformative tool that is reshaping how the health system operates.
“We’re still early in the process, but AI is already helping us reduce administrative burdens, improve efficiency, and enhance patient care,” Kos says.
As AI continues to evolve, Baptist Health is poised to remain at the cutting edge, leveraging technology to drive better outcomes for both patients and providers.
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Amanda Norris is the Director of Content for HealthLeaders.
KEY TAKEAWAYS
Baptist Health's AI initiatives in scheduling and claims management are cutting administrative burden and improving patient care.
Baptist is piloting AI for coding, aiming to reduce documentation queries and streamline revenue cycle processes.
AI is allowing Baptist Health to shift administrative staff into patient advocacy roles, enhancing patient satisfaction.