The way people are billed for their healthcare needs determines their whole experience, and as it stands, patients and providers alike are largely dissatisfied. AI has the power to change that.
Sixty-four percent of healthcare professionals say insurance claim denials are their top billing challenge, according to a recent study from healthcare software developer Tebra, and 54% site delays as the runner up. As a result, 54% of healthcare pros plan to adopt AI billing systems in the next one to two years, with 30% saying they've already done so.
"AI is transforming healthcare by automating administrative tasks, supporting more accurate diagnoses, and improving patient engagement," says Kevin Marasco, chief growth officer at Tebra. "[This] isn't just a trend — it's a long-term investment in operational resilience."
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Payer requirements, inconsistent coding and frequent denials have made medical billing a contentious issue for healthcare providers, creating inefficiencies throughout the process that have wasted both time and effort. In fact, according to Tebra's findings, nearly one in five providers spend over 20 hours a month just fixing billing errors.
"All of that time could have been spent on care," Marasco says. "Meanwhile, patients aren't being spared either."
In fact, they are just as overwhelmed as healthcare professionals. Forty-five percent of patients received an unexpected medical bill in the last year, according to the study, and 71% weren't able to negotiate the cost of their unexpected bill down. As a result, 44% of patients have even delayed purchasing essentials due to unexpected medical bills.
Implementing AI makes the process smoother and more efficient for everyone involved. AI can flag billing errors in real time such as fraud, mistakes in coding or data entry such as missing information before the claim gets denied. Machine learning can analyze denial patterns and offer suggestions as to why claims are rejected and provide solutions. Chatbots and AI tools can also interact with patients and answer their questions as they come up quickly.
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"Fewer mistakes means faster reimbursements, and less time spent on admin," Marasco says. "That's game-changing — especially for independent practices where every saved hour improves care quality and access."
However, how healthcare professionals manage the AI rollout is just as critical as the tech tools they use, and creating safeguards is imperative. Marasco urges providers to start with a clear map of current pain points and workflows. Then they can choose tools that integrate seamlessly with electronic health records. A phased strategy paired with training and compliance checkpoints can help teams adapt smoothly.
"Implementing AI the right way matters," Marasco says. "In a space as regulated as healthcare, accuracy and oversight are essential from day one."
