How the AI Billing Signed by the White House will Affect Your Health Plan

Summary:

The White House has introduced a groundbreaking executive order that holds significant implications for the world of artificial intelligence (AI). This directive represents a monumental shift in government policy, taking a comprehensive "whole-of-government" approach to AI, focusing on safety, security, and trust. While this order primarily addresses broader technology issues, it will undoubtedly impact the healthcare industry and health plans in a significant way.

Key Highlights of this Executive Order Include:

AI Safety and Bias Mitigation

Federal agencies are mandated to both deploy AI and actively combat its potential biases, ensuring fairness and equity in AI applications. In healthcare, this is particularly important to guarantee unbiased and equitable patient care.

Guidelines for AI Models

Developers of the most advanced AI models must adhere to new safety guidelines. These guidelines will play a pivotal role in ensuring the safety and efficacy of AI-powered healthcare solutions.

Industry Standards for AI-Generated Content

Government and industry standards for AI-generated content will be established. In healthcare, this is vital for the trustworthy use of AI in diagnostic tools, telemedicine, and data analysis.

Data Privacy and Protection

The order addresses data privacy concerns, setting guidelines for how personal information is collected, used, and shared. In healthcare, this will affect the handling of sensitive patient data.

AI in Healthcare

The executive order also emphasizes responsible AI deployment in healthcare, which implies that healthcare providers and insurance companies will face greater scrutiny in ensuring patient safety and data privacy.

The White House acknowledges that the healthcare sector, including health plans, relies heavily on AI and will be deeply affected by these new policies. As administrators of health plans, it is crucial to be proactive in understanding and implementing these changes to ensure compliance and maintain the highest standards of patient care and data security.

Furthermore, funding for these initiatives will depend on Congressional action. As we navigate this transition, we encourage you to stay informed and actively engage with policymakers to ensure that the needs and concerns of the health plan industry are addressed effectively.

This executive order represents a significant milestone in the evolving landscape of AI and technology regulation. While it may introduce challenges, it also presents an opportunity for innovation and improved healthcare delivery. We encourage you to collaborate and adapt to these changes to continue providing high-quality healthcare services to the American publi

How PCG Software can help during this Newfound AI Wave

Don’t wait for the US Government to mandate changes to your healthcare plan and risk millions in losses of non-compliance, overpaid claims, and lost efficiency. Act now and reap the benefits of PCG and Virtual Examiner.

Adapting to Regulatory Changes

Health plans are no strangers to regulatory changes. The recent executive order focusing on AI safety, security, and trust brings an additional layer of complexity to the healthcare industry. Health plans must adapt swiftly to these changes while maintaining the highest standards of patient care, data security, and compliance.

PCG Software recognizes the critical need for healthcare providers and insurers to remain compliant with evolving regulations. Virtual Examiner, a revolutionary software solution, is designed to help health plans navigate these regulatory challenges seamlessly with our AI Engine that continually updates changes in codes, compliance, and regulations. You don’t need to be part of CMS’ newsletter or have an inside contact, we are the contact, we are the software that can help you lead the way to faster growth through up-to-date knowledge.

What is PCG Software's Virtual Examiner?

Virtual Examiner is an advanced AI-powered tool that acts as a virtual compliance officer for health plans enabling pre-check run audits ensuring all of your claims are correct, and compliant, going back 3 years of each patient’s episode of care. Eliminating single pass views of the single claim, it examines coding violations, duplicate billing, split billing, and over 480 additional reasons a claim should be denied, pending for review, or maybe an instance of fraud.

Compliance Management

Virtual Examiner continuously monitors regulatory changes and assesses their impact on your health plan. It provides real-time updates and recommendations to ensure that your organization remains compliant with the latest regulations.

Data Security with VE

Since our AI never receives or stores names of providers and/or patients there is no HIPAA violations or PHI headaches. Additionally, our AI software merely gives you the reasons to make a decision, and the decision is ultimately left to your claims departments, medical management, and provider relations.

Efficient Workflow

Just imagine your claims team coming into work every morning and instead of reviewing 1000s of claims, they have one list of claims to review and they are given the reasons why it’s wrong as well as how to fix it.

Safeguarding Health Plans with Virtual Examiner

Health plan administrators must recognize that the executive order's focus on AI and data privacy has a direct impact on their operations. Compliance with the order's requirements is essential to avoid regulatory penalties, maintain trust with patients, and achieve operational excellence. By adopting VE into your Plan in the next 30-90 days you are ahead of the curve and behind it.

Take the Next Steps in AI Adoption Today

The White House has made its decision to accept AI within Healthcare but also established rules and guidelines to which it can be applied. Lucky for you, PCG has already done all the work for you by developing VE over the past 30 years.

If you want to know more about VE and get a FREE 3-year claims audit ($50,000 value), please fill out our form or call us today. CLICK HERE