Why Agentic AI Is Not a Denial Silver Bullet with Chris Spady | Podcast Shorts from ArceeHQ

In this clip

Chris Spady offers an honest assessment of what agentic AI can and cannot do for claims denial management. He acknowledges that the industry has moved from cautious observation to "go go go" in under 18 months, and that Erlanger Health does not want to be left behind. But he is direct that AI will not solve the industry's denial problem, because denials are too profitable for payers and payer-side AI is already ahead. The case for adoption is not transformation but competitive parity, and he sees the primary near-term opportunity in cost reduction through AI-assisted workflows rather than in eliminating denials at scale.

Key Takeaway

Agentic AI in revenue cycle is a competitive necessity, not a solution to the industry's denial problem. Organizations that adopt it will reduce costs and stay current with health systems investing in the technology. Organizations that do not will find themselves chasing payers that are already ahead.

“I don’t think it’s going to solve the industry’s denial problem. That’s just too big of business on the payer side, to be frank. But if we don’t keep up with the rest of the health systems, it’s going to be hard for us to be successful.”
Chris Spady, Senior Vice President of Revenue Cycle, Erlanger Health

Agentic AIClaims Denial Management

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Chris Spady

Season 2 · Episode 6 · 44 min

Winning the Claims Denial War: Clinical Denials Management, Agentic AI, and the Ownership Mindset That Drives Results

Chris Spady · Senior Vice President of Revenue Cycle, Erlanger Health

Chris Spady brings a senior revenue cycle leader's perspective on why claims denial management is a permanent strategic initiative and why the shift from technical to clinical denials has fundamentally changed how health systems must respond. Drawing on experience across multiple major health systems and his return to Erlanger Health as Senior Vice President of Revenue Cycle, he explains the governance and operational layers his team uses to drive ownership throughout the organization, the benchmarking tools that provide apples-to-apples comparisons across health systems, and a workflow software implementation designed to ensure follow-up teams work the right accounts at the right time. Chris shares his honest view on agentic AI, why it is unlikely to eliminate the clinical denials management problem but represents a genuine opportunity for cost reduction and coding automation, and why the real opportunity in denials prevention lies not in chasing high-dollar claims but in systematically eliminating the thousands of low-dollar denials that drain staff resources. He closes with leadership lessons from a Navy SEALs masterclass on simplified decision-making and the ownership mindset he believes separates high-performing revenue cycle teams.

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