Ambience’s suite of AI applications includes:

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AutoScribe: A real-time AI medical scribe that generates comprehensive notes across all clinical specialties–including emergency medicine and hospital medicine–and integrates directly with all major EMRs;

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AutoCDI: A point-of-care CDI assistant that analyzes conversations and past EMR context to ensure that ICD-10 codes, CPT codes, and documentation all appropriately support each other, as well as full audit trails for revenue cycle teams;

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AutoRefer: AI software that improves handoffs by composing clinically relevant and well-organized referral letters to specialists for expert consult and from specialists back to primary care for long term management;

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AutoAVS: An after-visit summary tool that creates comprehensive educational handouts for patients, families, and caregivers, tailored specifically to each visit, and translated into their language of preference;

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AutoPrep (coming soon): Intelligent pre-charting that equips clinicians with relevant context and suggestions for the visit agenda, along with predictive 'suspecting' to unveil potential conditions for screening.

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https://www.prnewswire.com/news-releases/ambience-healthcare-raises-70m-to-scale-the-most-comprehensive-ai-operating-system-for-healthcare-organizations-302054056.html

Ambience Healthcare partnered with Pediatric Associates -- the largest private pediatric primary care group in the United States -- to co-create the single best AI solution for pediatrics. Ambience was designed to support the unique care model, workflows, and coding and billing requirements of pediatrics.

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https://www.prnewswire.com/news-releases/pediatric-associates-and-ambience-healthcare-partner-to-redefine-pediatric-care-with-generative-ai-302092581.html

• John Muir Health 
• University of California, San Francisco
• Memorial Hermann Health System
• St. Luke's Health System (Idaho)
• Eventus WholeHealth 
• Pediatric Associates
• Alpine Physician Partners
• Cityblock Health

Industries: Healthcare, RCM

Provider Systems: Epic

Payer Portals: eviCore, United Healthcare, Magellan

Challenge

A large healthcare provider needed to ramp up their automation strategy to offset labor instability and attrition. Currently the staff manually have to go out to payer portals, submit requests and check statuses of Prior Authorizations, sometimes multiple times. Through Task Mining AI (Artificial Intelligence) analysis, it was determined that staff were spending about 30 – 40% of their time submitting requests and checking the status for 19,000 prior authorizations per month.

Prior Authorization Requests: 3 bots processing prior authorization requests in 3 separate portals (EviCore, Magellan and UHC).

• EviCore: 923 transactions per month
• Magellan: 595 transactions per month
• UHC: 7,063 transactions per month

Prior Authorization Statusing: 3 bots processing prior authorization statuses in 3 separate portals (EviCore, Magellan and UHC).

• EviCore: 5,536 transactions per month
• Magellan: 3,572 transactions per month
• UHC: 986 transactions per month

Solution:

RPA bots are a much more accurate and effective solution to verify the status of patient health authorizations, RPA bots can repeatedly check requests under review for status changes and updates.

CampTek Software was engaged because of its healthcare and Epic experience. Through task mining, AI models were created, and results were reported back to the customer with enormous success. The next phase of design and build all occurred in a brief time. The bot now in production includes business rules, exception handling and daily reporting functionality. It is also supported by CampTek as an ongoing managed service solution for the provider.

The Bot is now saving 2,696 FTE (full-time employees) hours per month or 32,352 hours (about 3 and a half years) per year. The FTE capacity gain is 17 FTEs (full-time employees), and the ROI (Return on Investment) is $1,085,000 per year.

Any healthcare provider