top of page
AI Machine Learning (ML) in RCM

        Artificial Intelligence (AI) IN RCM   
     MEASURe | MONITOR | MONETIZE

Women Owned Business Certified Logo
Women Owned Business Certified Logo

Our
Approach

P3 Quality is an emerging Artificial Intelligence (AI) Tech company.

​

We assess AI and Revenue Cycle Management (RCM) quality assurance Automation tools, processes, and systems for vendors, suppliers, hospitals, and providers.  

 

​​​​​​​​​ARTIFICIAL INTELLIGENCE (AI) EXPERTISE 

As Independent Evaluators, we perform rapid-review quality assurance audits. Inspecting AI and RCM-related governance and remediation inconsistencies, inefficiencies, pattern-recognition issues, and process failures.​​​

​

AI CORE ISSUES

  • Drifting Off a Cliff​​​​

  • Going Rogue

  • Hallucinating Errors 
  • Misfiring Training Prompts 

 

P3 SOLUTIONS:​​

  • People, Processes & Principles 

  • Human-in-the-Loop Oversight

  • Diagnosing AI Issues

  • Identify/Prioritize inconsistencies & inefficiencies

  • Measure & Capture Success Metrics/Trends

​

TRUSTED & UNBIASED TOOL CHEST​​​

  • ISO 9001, CMS, MAC, HIPAA, PHI, TPA, etc

​​​ ​​​​

 

RISK REMEDIATION SERVICES

  • AI AuditME™ Q-Check Rapid Review

  • Governance Remediation Frameworks​

 

P3 QUALITY Dual Certifications WBE / WBENC and a Georgia (SBSD) Certified Small Woman-Owned Business.

Our
Methodology

AI AUDITME™ 

Q-Check Rapid Review  Methodology: Corporate, Accountable, Responsible,

and Ethical Use of AI:

​

​​​​ISO-9001 ALIGNED STRATEGIES:

  1. Corporate Governance and Disclosure 

  2. Transparency 

  3. Risk Mitigation and Internal Controls 

  4. Regulatory Oversight | Quality | Compliance 

  5. AI Third-Party Systems and Data Risks​ 

P3 FOCUS | AI PERFORMANCE GAPS

HUMAN-CENTRIC AI

We are Human-Centric AI Smart Specialists

​​

EVALUATING AI LLMs OR AGENTIC ERRORS​

  • AI/Automated Task Flaws

    • Data Input/Output Issues​​

​

THE QUALITY/COMPLIANCE RISK IMPACT

  • Flaging AI Model risks

    • Drift​​

    • Hallucinations

    • Misfires

​​

AI DEFENSIBILITY 

  • Identifying/Explaining AI System Spikes

    • Algorithmic Failures 

    • ​Risk Exposure 
    • Rework

 

TYPICAL BARRIERS

  • Selective Transparency​​​​​​​​

  • AI Dependency/Trustworthiness

  • Budgetary Constraints

AuditME™ FRAMEWORK

 

AI-RCM GOVERNANCE REMEDIATION 

Automate and Regulate Checks/Balances

  • Coding/CDI Governance ​​​​​

  • Risk Exposure 

  • Compliance

​​​

ETHICAL OVERSIGHT

  • Human-In-The-Loop (HITL) Supervision

  • Algorithmic Bias Audits & Monitoring 

  • Transparent AI & Explainability Guidelines

​​​​​

STANDARD OPERATING PROCEDURES​​

Build SOP Strategies:

  • Up-to-Date SOP Manual Review or Dev

  • Human Sign Off on Patterns/Process Risks

  • AI-Driven Transparency and Accountability Reporting 

​​

RESPONSIBLE AI: 

  • An Internal Authority Must be Assigned as the AI Standard Bearer

    1. Set an AI Quality Bar​

    2. AI Policy Framework Ownership

    3. Bridge Operational /AI Ethics Gaps

    4. Champion Governance Across All AI Driven Functional Areas

    5. Schedule Regular Measure, and Monitor  Audit Activities

  • Implement AI Impact Assessment Requirements 

  • Codify Core AI Development Standards

  • Establish Third-Party Data & Systems Remediation Accountability​​​​

​​

AI-RCM RELATED ISSUES

  • Patient Access/Registration 

  • Eligibility/Benefits Verification 

  • Prior Authorization Systems 

  • Clinical Documentation Integrity (CDI)

  • Computer-Assisted Coding (CAC) 

  • Charge Capture Systems 

  • Charge Description Master/CDM Logic

  • Denial Prediction Systems

  • Denial Management Systems

image.png

MEASURE | MONITOR | MONETIZE

P3 Quality Logo

 

​Copyrights 2022–2027 P3 Quality®, LLC - All Rights Reserved      

    Designed by Elev8 Marketing Solutions

    bottom of page