To reduce delays and deferrals for our clients, and to share feedback with our clinicians sooner, NSM's Revenue Cycle Leadership Team has been partnering with vendors for the past nine months to test automated AI software that evaluates medical documentation and compares it to the payor requirements. 

Initially, the focus was on Medicare, specifically, HCPS codes K0005, E1161, K0861, and K0856, as their coverage guidelines are publicly published and straightforward. 

After evaluating 14,000+ orders and comparing results against actual responses received from PAR and ADMC, the success rate remained steady at 99.5% accurate.

Based on the 99.5% success rate, the Revenue Cycle Leadership Team launched a pilot of the AI automation in January that included 7 NSM branches across all divisions. Because of the success we saw at our branch locations, we are excited to expand the automated AI order support tool across all U.S. locations beginning on March 3. 

We are excited to launch this technology into the Funding process so that we can see the benefits across ALL of NSM!

If you have any questions, please contact Kevin Harmon, NSM VP of Billing & Reimbursement.