Case Study: Uncovering Denial Trends Using Agentic AI Presented by Sourabh Agrawal & Jonathan Gerber
Many payers still send only paper explanations of benefits (EOBs), locking valuable payment and denial insights in static formats. In this session, we’ll demonstrate how an agentic AI“employee” converts these paper EOBs into structured data, verifies line-by-line payment status, posts results back into the HIS, and streams the extracted fields into an analytics layer that surfaces denial trends. By mapping plan-specific denial codes, contract discrepancies, and recurring documentation gaps, the agent helps identify root causes of revenue leakage—while also automating manual posting and driving significant labor savings. Attendees will leave with a step-by-step playbook for deploying goal-oriented AI agents to convert paper remittances into real-time dashboards, reduce denials, and improve A/R velocity.
Course Participants will be able to:
- Leverage Agentic AI to identify root cause behind loss of revenue and get key insights on what systematic errors are driving the most denials.
- Leverage Agentic AI to analyze paper-based EOBs, the (technical) challenges to expect and a playbook to resolve them.
- Leverage Agentic AI to automate the payment posting and denial assignment process to reduce expensive FTE workforce