The Albany Gazette - AGS Health(R) Introduces Agentic Digital Workforce Solutions to Tackle Rising Claim Denials and Margin Pressures

"Labor-intensive processes, fragmented RCM ecosystems, and continuously shifting payer rules have put healthcare finance leaders at a disadvantage," said Patrice Wolfe, CEO of AGS Health. "CFOs are now dealing with alarming denial trends and significant financial threats that demand new strategies led by a collaborative digital RCM workforce built for scalability and engineered for impact. Through agentic AI, AGS Health empowers healthcare leaders with digital agents that work alongside their teams, taking on autonomous tasks and recommending data-driven next steps to improve decision-making."

Market Pressures Driving Urgent Change

Lower reimbursements and denials are cited by 84% of health system leaders as the top drivers of declining margins. With global healthcare RCM software and services spending projected to grow from $42.6 billion in 2024 to $65.7 billion by 2031, investment in automation is accelerating. According to a recent Black Book Research survey, within the first six months of adopting AI-powered RCM solutions:

• 83% of organizations saw claim denials reduced by at least 10%.

• 68% reported improved net collections.

• 39% saw cash flow increase by more than 10%.

A New Class of Digital RCM Workforce

"AGS Health is answering the call for change with AI agents that level the playing field for overburdened RCM teams," said Thomas Thatapudi, CIO of AGS Health. "Our next-generation, AI-infused workforce solutions bring speed, agility, accuracy, and human-like decision-making to critical RCM functions such as eligibility verification, prior authorizations, denials management, and appeals."

AGS Health was recently recognized with a UiPath AI25 Award for its pioneering use of agentic AI to help healthcare organizations reduce the financial impact of denials. Its digital workforce features AI agents that understand natural language, adapt to changing rules and workflows, and make autonomous decisions to drive measurable business outcomes, including fewer denials and higher clean claim rates.

Key benefits include:

• Financial: Faster reimbursement and lower cost-to-collect

• Operational: Improved staff efficiency and focus on high-value work

• Quality: Fewer errors in coding, data entry, and appeals

The Hybrid Intelligence Advantage

While AI systems can act autonomously, RCM professionals remain central to a successful digital workforce model. Skilled specialists help train and refine the AI, driving strategy while maintaining oversight and accountability.

"Our hybrid intelligence model combines AI's speed, accuracy, and scalability with human expertise and empathy," added Thatapudi. "AI agents manage high-volume tasks while professionals handle exceptions and guide continuous improvement. This can be achieved in-house domestically or through our globally distributed workforce model to reduce operating costs and allow for 24/7 production schedules."

By preparing work, surfacing insights, and managing exceptions, AGS Health's AI agents empower RCM teams to make smarter, faster decisions without compromising quality.

For more information on AI agents and digital workforce solutions from AGS Health, visit https://www.agshealth.com/ai-platform/ai-agents-and-intelligent-automation/.

About AGS Health

AGS Health is more than a revenue cycle management company-we're a strategic partner for growth. Our distinctive methodology blends award-winning services with intelligent automation and high-touch customer support to deliver peak end-to-end revenue cycle performance and an empowering patient financial experience.

We employ a team of 15,000 highly trained and college-educated RCM experts supporting customers across diverse care settings and specialties, including nearly half of the 20 most prominent U.S. hospitals and 40% of the nation's 10 largest health systems. Our thoughtfully crafted RCM solutions deliver measurable revenue growth and retention, enabling customers to achieve the revenue to realize their vision.

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Media Contact:

Liz Goar
NPC Creative Services
[email protected]

SOURCE: AGS Health

View the original press release on ACCESS Newswire

(O.Robinson--TAG)