Julian Herbert , 2025-05-07 13:40:00
Patient intake is time consuming and costly for medical practices and irritating for patients. Most of the time is spent on insurance matters — specifically, confirming that a person still has insurance, and which plan.
But for the practice, the work doesn’t end there. While patients are generally able to log on to their insurer’s web site to confirm details like which providers are in network and which procedures are covered, providers must call each insurance company for nearly every patient appointment to confirm coverage. Each call takes 5-10 minutes (more if the service involves a specialist or any sort of complication).
A busy provider might see 30 patients a day, and most practices have multiple providers. That means each practice might spend the equivalent of one full-time person for a full day each week per provider just manually confirming medical coverage for patients. Five providers in a practice means a full-time staffer dedicated just to this task. Those roles can be hard to fill as the work is boring and repetitive.
But AI and automation are changing that. As AI has evolved to be more accurate and reliable, it’s become suitable for high-stakes use cases including automating health insurance verification — and providers who are using it say it’s a game-changer in their practices.
Replacing individual phone calls with automated, real-time eligibility verification
Checking insurance eligibility and coverage is important for ensuring providers get paid. When procedures are pre-verified, insurance claims are paid faster and are far less likely to be denied. Verification also helps make sure patients don’t receive unexpected bills after the fact for care that’s not covered, and reduces the burden on clinical staff to provide billing support for confused and frustrated patients.
It’s now possible to verify insurance and specific coverage before the patient even comes to the office, using AI. Providers can batch submit requests through marketplace platforms for all the following day’s appointments or even automate real-time verification when a patient books an appointment. Those requests are routed to the appropriate insurer, and providers receive verification (or declines with specific explanations) almost instantly. When a patient arrives for an appointment, staff can skip verification if they’re all set or alert the patient if a procedure won’t be covered — so they can make an informed decision about whether to continue with the appointment. No lengthy phone calls with insurers are required, and staff need only spend about one minute on verification for each patient.
Providers can move to real-time eligibility checks using an AI platform, eliminating the need to confirm eligibility and coverage after appointments. When coverage can’t be verified or is denied, providers need to chase patients for payment — frustrating for both provider and patient. Real-time eligibility confirmation at time of booking eliminates out-of-pocket surprises for patients and the need to chase payment after the fact.
Ensuring patient insurance and contact data is accurate leads to speedy reimbursement, prevents downstream billing issues and streamlines follow-up.
Reducing insurance denials
An Experian Health survey of providers found that typically 10-15 percent of claims are denied. Often denials are related to inaccurate patient info, incorrect or outdated coverage status, and lack of insight into coverage limits. Real-time eligibility eliminates most of these problems. In fact, providers who move to real-time eligibility verification also see a 50 percent reduction in denials, because they are able to confirm or correct these details before services are provided.
In today’s healthcare climate, the intake process is more than a formality. It’s the first impression. It sets the tone for trust, efficiency, and financial clarity. By reducing paperwork fatigue, improving cost clarity, and freeing staff from repetitive administrative tasks, practices can focus more on patient care and less on paperwork.
The healthcare industry, often slow to adopt new technology, is poised to make huge productivity gains from AI. In the case of intake, AI can create a smoother, faster and more accurate process that’s better for both patients and providers.
The author wishes to thank colleague Ebbonne Cabarrus for her assistance with this article.
Image: Thai Noipho, Getty Images
Julian Herbert started his career in tech product development as a business analyst focused on e-commerce in the semiconductor industry. Following his curiosity, he became a management consultant at Deloitte and led M&A divestiture and integration engagements in a variety of industries, including pharma and biotech. He then transitioned back into product development and e-commerce at Amazon, launching machine learning solutions for 3rd party sellers on the platform. Julian was also tasked to lead product development for AWS Startups, building their first micro-targeted product line.
At DoseSpot, Julian leads product innovation, helping the company grow and deliver safe and reliable ePrescribing technology and software integrations across multiple healthcare markets. Julian is originally from Louisiana and graduated as valedictorian from Southern University in Baton Rouge with a B.S. in Computer Science. He also has an M.B.A. from The Ross School of Business at the University of Michigan, focusing on strategy and entrepreneurship.
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