Harnessing AI to Transform Urgent Care Centers: Improving Efficiency, Morale, and Profitability
–Lohith Reddy, Executive Vice President
Artificial Intelligence (AI) is transforming healthcare, and Urgent Care Centers (UCCs) stand to benefit significantly from its capabilities. With AI-powered coding and clinical documentation improvement (CDI) solutions, Urgent Care operations can streamline processes, boost provider morale, enhance care quality, and increase profitability. By addressing common Urgent Care challenges—ranging from provider burnout to revenue cycle management (RCM) issues—AI can revolutionize Urgent Care operations.
How AI Can Solve Operational and Financial Challenges
- Optimizing Revenue Cycle Management (RCM)
AI can streamline RCM by automating claims submissions and handling denial management with incredible speed and accuracy. Claims that took weeks to process can now be edited and submitted in days. Some AI tools, like those from Exdion Health, can scrub a day’s worth of claims in just 24 hours. AI can also identify opportunities to adjust E&M levels and will query the provider to input additional information to support the higher level, leading to increased revenue. It can also identify where documentation cannot support a level increase. The AI will lower the coding level, ensure every service is billed correctly, increase compliance, and protect Urgent Care Centers in case of audits.
AI’s accuracy helps Urgent Care Centers get paid faster while minimizing billing errors. With improved cash flow and fewer rejected and denied claims, centers can optimize their financial health.
- Tackling Staffing Challenges with AI
Staffing shortages and burnout are pressing concerns for many healthcare providers. A CDC study on healthcare worker burnout concluded clinicians reported less burnout when they had enough time to complete their work and be productive. To drill down even more, a study published in JAMA Health Form noted some of clinicians’ top-ranked burnout interventions (ranked as “very important” to their well-being by over 50% of clinicians) were:
- Improving team communication
- Creating an environment where clinicians can spend more time in direct patient care
- Adding resources to support new-to-practice clinicians
AI can reduce clinician burnout by automating time-consuming tasks like coding and documentation. AI systems like Exdion’s ProMax AI can even provide real-time feedback and education to clinicians, giving them simple resources to fine-tune their documentation and coding skills targeted to their unique education needs so no time is wasted. By providing actionable feedback and data, ProMax can also improve team communication. Utilizing AI tools will create an environment where providers spend more time with patients and less on paperwork.
- Enhancing Patient Experience and Care Quality
AI-powered coding tools ensure that every visit is documented thoroughly, leading to more accurate medical records that improve patient outcomes over time. By automating mundane tasks such as documentation and coding queries, AI frees up clinicians’ time, allowing them to focus on direct patient care. This can result in more comprehensive visits or reduced wait times, enhancing the patient experience.
- Data-Driven Decision Making
The ability of AI to analyze vast datasets enables Urgent Care Centers to make more informed decisions about staffing, budgeting and operations. Predictive analytics can forecast patient demand by busiest days, times and treatment trends. This can help centers optimize staffing levels and resource allocation, allowing for better resource management and strategic planning.
Overcoming Implementation Challenges
Many Urgent Care Centers may have had negative experiences implementing new technologies, particularly those not designed with healthcare in mind. The process can be overwhelming, the technology can interrupt workflow, and it can feel like a waste of time and money. When implementing AI technology, here are some things to consider:
- Integrating AI with Existing Systems
Seamlessly integrating AI with current EHR/EMR systems is crucial. Centers should select AI tools that wrap around their existing infrastructure without disrupting workflows or compromising security. Some companies like Exdion may provide pilot programs so centers can test AI’s effectiveness in smaller settings before full deployment, minimizing risks.
- Ensuring Data Quality
Clean, accurate data is essential for AI success. Urgent Care Centers should ensure that their AI providers prioritize data integrity and employ manual quality control checks by qualified professionals to ensure reliable outcomes.
- Training and Support for AI Tools
Comprehensive training and ongoing support are necessary for AI adoption. With Exdion, a dedicated team of experts guides Urgent Care Centers through the integration process, ensuring staff members understand how to use AI tools effectively and are readily available to answer questions. Choosing AI tools from a company that provides continuous and timely support is imperative to optimizing results.
Transforming Urgent Care Groups (Or Centers) with AI
While AI coding tools are still too new to have enough data to definitively prove their ROI, there is still anecdotal evidence that they are making a positive impact. Several large Urgent Care groups that have tested Exdion’s coding tools in one or several of their centers are now rolling out these tools at all their UCCs. These “try before you buy” tests have led to hundreds of UCCs utilizing AI coding and CDI tools, which provides evidence of the efficacy and benefit these centers are seeing.
AI allows Urgent Care Centers to improve operational efficiency, reduce provider burnout, and increase profitability. By adopting AI solutions, they can stay competitive and sustainable in an ever-evolving healthcare landscape. If they are working with a provider who can ensure their products’ efficacy and will help centers overcome implementation challenges, now is the optimal time to explore AI as a tool to enhance patient care, streamline processes, and optimize revenue.
About Exdion Health
Exdion Health is a pioneering leader in the healthcare industry, delivering digital transformation solutions through its innovative SaaS+ model, which sets it apart from traditional outsourcing companies and pure tech players. While standard SaaS offerings address 70–80% of operational volumes, Exdion Health’s SaaS+ approach goes further by blending cutting-edge AI platforms with a human-in-the-loop methodology to seamlessly handle exceptions.
When the AI platform encounters complex scenarios beyond its current processing capabilities, the human-in-the-loop mechanism identifies data drift and simultaneously manages ML Ops, enabling the AI engine to continuously learn and evolve, becoming smarter and more effective over time.
Exdion Health takes full ownership of operational challenges, bridging the gap between technology and human expertise to deliver seamless, tailored solutions that empower businesses to achieve unparalleled accuracy, efficiency, adaptability, scalability, and consistency.