Healthcare
Transformation Without Disruption: How Access Healthcare Is Rewiring the Revenue Cycle with Agentic AI
Hospitals are juggling shrinking margins and rising costs while denial volumes remain stubbornly high. In the revenue cycle alone, hundreds of billions are lost annually to preventable errors and inefficiencies—in fact, Access Healthcare CEO Shaji Ravi cites more than $250 billion wasted each year. Meanwhile, payers have accelerated their use of AI to adjudicate…
Key takeaways
Fix documentation and coding upstream with tools like SmarterDX to reduce the persistent 40% of claims that don't pay cleanly on first submission.
Agentic AI with self-learning 'knowledge streams' moves beyond static RPA rules, spots root causes, and propagates fixes across thousands of claims under human governance oversight.
A modular, zero-disruption rollout wrapping AI around existing EHRs requires near-zero IT lift and can yield roughly 50% people cost reduction in early phases.
Hospitals are juggling shrinking margins and rising costs while denial volumes remain stubbornly high. In the revenue cycle alone, hundreds of billions are lost annually to preventable errors and inefficiencies—in fact, Access Healthcare CEO Shaji Ravi cites more than $250 billion wasted each year. Meanwhile, payers have accelerated their use of AI to adjudicate and deny claims. Against this backdrop, a practical question has turned urgent: can health systems modernize fast enough without derailing day-to-day cash flow?
What would it take to deploy AI across the revenue cycle without a painful rip-and-replace—and actually cut operating costs by half?
On this episode of Highway to Health, host David Kemp talks with Shaji Ravi, the CEO of Access Healthcare, which is now part of Smarter Technologies (alongside SmarterDX and Thoughtful AI). They unpack a blueprint for “transformation without disruption,” covering front-end CDI and coding, mid-cycle automation, and back-end denials/AR—plus the governance needed to keep AI reliable and compliant.
Key highlights from the episode…
- Front-end first: Fix documentation and coding upstream (SmarterDX) to reduce downstream rework; 60% of claims pay cleanly, but the persistent 40% problem starts before submission.
- Agentic AI with humans-in-the-loop: Move beyond RPA’s static rules to self-learning “knowledge streams” that spot root causes, propagate fixes across thousands of claims, and are audited by governance teams—no “rogue bots.”
- Zero-disruption rollout, real ROI: Wrap modular AI around existing EHRs, require “near-zero” IT lift, and phase savings: ~50% people reduction in the first months as agents take on denial management, coding assists, posting, and AR follow-up.
Shaji Ravi has spent nearly 30 years in the U.S. healthcare revenue cycle, beginning in the mid-1990s and ultimately co-founding and scaling Access Healthcare to 27,000+ specialists across the U.S., India, and the Philippines. Now the CEO of Access Healthcare within Smarter Technologies, he’s leading the integration of service delivery (Access Healthcare), clinical/front-end intelligence (SmarterDX), and agentic automation (Thoughtful AI) to help providers cut costs and improve collections—without changing core systems.
Article written by MarketScale.
About the author
With experience in coaching college basketball, supporting large healthcare systems through ICD-10, to now leading the healthcare vertical at MarketScale, David enjoys the journey. Craving knowledge is one of David's core values, and he has the opportunity to learn from some of the best as host of the Highway to Health podcast series.
