In recent years, the rapid advancement of artificial intelligence (AI) technology has revolutionized various industries. Workers who implement AI into their workflows can see up to 40% increase in productivity.
Case management is no exception. It can be a time-consuming process, particularly with outdated legacy systems that lack intuitive interfaces or require manual data input. For organizations to efficiently handle complex cases, track information, and streamline processes, case management systems are critical.
With the integration of AI capabilities, next-generation case management systems offer significant improvements in accuracy, efficiency, and decision-making. Let’s dive into different types of artificial intelligence for case managers and four critical ways they can streamline typical processes.
Types of AI Beneficial to Case Managers
Case management is a complex and dynamic process that involves coordinating, planning, and delivering services to individuals or groups with diverse needs and goals. Case managers must constantly adapt to changing circumstances, regulations, and expectations while ensuring quality, efficiency, and compliance. Artificial intelligence (AI) can help case managers overcome these challenges and improve their outcomes and performance.
Four general categories of artificial intelligence can be beneficial to case management processes.
1. Automated Classification and Routing
Imagine that details could be automatically sorted into the proper case file. It’s possible with an AI tool generally called “automated classification and routing.” With this algorithm, the system examines the data and classifies it based on specific requirements. This can be done for all kinds of files, including text, images, video, and audio.
Hypothetically, a case manager could take an audio message of a case note, then the automated classification and routing system could transcribe it and attach it to relevant files. It can also be forwarded to the proper team or department. This takes out human error–no one would accidentally kept out of the loop.
2. Predictive Analytics
Case managers often wish they could see the future and best understand how to care for a client. While it’s not perfect, predictive analytics is as close as we can get. Predictive analytics tools take a large portion of data, such as the type found in case management software, and answer the question “What will happen next?”
This has endless applications for case management. Predictive analytics tools can take information from past cases to proactively identify potential issues in current ones. Case managers can take corrective action sooner, solving problems and quickening the case management process. Solutions are found faster, resulting in faster case turnaround time and increased client satisfaction.
3. Natural Language Processing (NLP)
Programs such as ChatGPT are powered by natural language processing, which is a specialized language model that teaches computers to process language the same way that humans do. According to the Harvard Business Review, NLP is the most promising for businesses in “writing, coding, and discipline-specific reasoning.”
NLP has many implementations in case management. An NLP could synthesize case notes into a summary, write the first draft of an email, or write relevant questions for client intake.
The intent behind client inquiries can be analyzed using natural language processing. This increases the case routing’s correctness and ensures that cases are handled quickly. NLP can go beyond intent by extracting or emphasizing important information like contact information, account numbers (with confirmation), stated products, dates, etc. Additionally, it can automatically redact PHI and PII before it reaches the employee.
4. Chat and Voice Bots
Conversational AI-driven chat and voice bots can be used to address frequent consumer questions and give prompt answers. Bots handle the early steps, which lessens the workload of case managers and front office staff while speeding up client response times.
It also helps clients find answers to their questions. These tools can help clients find simple answers without interrupting case managers–critical to boosting productivity.
4 Ways Case Management Benefits From Artificial Intelligence
Case management is a complicated process that requires many different people from different systems to coordinate a care plan. It includes case managers, social workers, doctors, therapists, administrative professionals, and more. Implementing AI streamlines communication and administration between all these individuals and allows case managers to spend more time doing what they’re passionate about: caring for their clients.
1. Improved Patient Advocacy
Case managers act as the main advocate for their clients, to ensure they receive the services and care needed to maintain stability. Patient advocacy can be improved through artificial intelligence, allowing case managers to encourage clients to be self-empowered.
For example, AI can be a powerful tool to diagnose certain conditions within healthcare. Educating clients on how these tools are used teaches patients to understand the system. This can encourage them to continue seeking treatment and access education on their terms, an end goal for many cases.
AI can also connect patients to resources they may not have been able to access. It can collect information or links so it’s all in one place, creating equity and increasing quality of care.
2. Battling Denials With Evidence-Backed Data
Particularly relevant in medical case management, insurance claim denials put all the cost pressures on the organization or individual. However, artificial intelligence can analyze previous cases to find the best solution for approval. AI can help determine:
- Why the claim was denied
- Which denials are the most likely to succeed in their appeal
- The best revenue integrity opportunities
In general, AI can be a great tool for any area that needs data-driven decision-making. AI pulls data from many different sources and offers suggestions for the best way forward.
3. Improved, Cost-Effective Administrative Processes
Administrative workflows can be some of the most time-consuming portions of the case management process. Communicating with other relevant parties, writing and sharing relevant case notes, and keeping detailed work records eat away at a case manager’s day. Artificial intelligence such as NLP and automated classification and routing offer tools to streamline these areas. Case notes can be summarized for case management software in seconds with NLP, and automated classification and routing allow for critical data to be shared with relevant parties automatically.
Additionally, artificial intelligence can lower administrative costs. Appointment scheduling, client intake or registration, and insurance checks have typically been completed by administrators or case managers in the past. These simple steps can now be automated through case management, with a potential savings of 13.3 billion a year.
4. Improved Outcome-Driven Support Services
Case managers create case plans based on ideal outcomes. Artificial intelligence can help drive these plans with past data to personalize outcomes for the ideal solution. It can even be as specific as anticipating when a client will need to leave the hospital. This high level of data means that case plans can be more accurate, and case managers can better plan to meet client needs.
Every case is unique, and AI can support case managers through chatbots or voice bots. These small interactions can help clients become more involved in the process. Additionally, 80% of patients prefer digital communication channels. Opening these up with AI can encourage client engagement for more positive outcomes.
AI Tools Are the Future of Case Management
Today’s business landscape is changing fast as businesses grow more familiar with the capabilities of artificial intelligence. Even in its early stages, organizations may use AI to automate repetitive operations, offer data-driven insights, and support decision-making processes in real time to aid case managers in increasing productivity, cutting costs, and improving customer experience.