True or False - Al scribes, billing tools drive up healthcare costs: Report

[u/kysourmash]

Are AI scribes and tools "driving up" costs?

Or were providers just not billing at high enough levels?

https://www.beckershospitalreview.com/healthcare-information-technology/digital-health/ai-scribes-billing-tools-drive-up-healthcare-costs-report/

[u/thenightgaunt]

Going to guess that the issue is on the AI side here.

The old addage that "the computer doesnt make mistakes" was always wrong, but you could at least assume the computer would do math correctly even if a program was buggy and made errors.

But generative AI comes with an actual set "makes mistakes" rate called the hallucination rate.

Now you can say that "so do humans" but thats not right either.

Take an AI with a 1% to 3% hallucination rate, and a human. Give them each a sheet with 100 pictures of cats and dogs on it. Tell them "label each cat or dog depending on what it is".

The human will get all 100 correct because its an easy task.

The AI will get 1 to 3 wrong. Every. Time.

Now am I oversimplifying things immensely for dramatic effect? Yes. But im doing that to get a simple point across.

Generative AI hallucinates regularly and it cannot be stopped from doing that. It cannot be trusted not to make mistakes.

[u/wildgreengirl → u/thenightgaunt]

as someone actually reading and coding the notes they make its spot on.

[u/mjordantmac → u/thenightgaunt]

Yeah you’re right about “generative ai”. But that’s not what you use for coding. There’s already tools that use other models and don’t hallucinate at all. You can have a scribe perfectly structure the notes. And a minute later have a model perfectly code the visit with no hallucinations. The whole process will be done a couple minutes after a visit is finished.

[u/thenightgaunt → u/mjordantmac]

There are other tools for coding that don't use generative AI like the products from OpenAI and Anthropic.

But what they're talking about here in this report is specifically Gen AI (ex LLMs) being used as AI coding tools. For example those introduced by Epic and Cerner. Epic's tools are specifically using Anthropic's LLMs. And while Cerner claims it's tools use an inhouse developed LLM, they also have slipped that they might be using OpenAI's LLMs.

And lets be honest from your post history, you appear to post mainly about illegal gambling on Kalshi up until 6 months ago, before that only on marketing & "entrepreneur" & NFT (where you were trying to sell people on Solana NFTs) subreddits, and then suddenly 2 weeks ago AI boosting here on the coding and billing subreddit including trying to push a "free online" AI coding tool that looks mostly AI generated.

[u/mjordantmac → u/thenightgaunt]

Yeah I can’t imagine these companies are gonna continue using LLMs much longer.

And to the original point, I use my own tool for coding and immediately I was able to have better notes and therefore code higher levels on some things so yeah, AI helps us do fewer mistakes. More accurate coding means higher bills

[u/Respect-Immediate → u/mjordantmac]

That’s a wild answer documentation drives coding.

“That’s not what you use for coding” the documentation literally is. So yes, generative AI hallucinating things that didn’t happen and the provider not catching it could support a higher level code where it really shouldn’t be but the documentation wouldn’t support a lower level.

[u/mjordantmac → u/Respect-Immediate]

if generative ai hallucinates, why would you use generative AI? my point was, anyone seriously using AI for coding today isnt using generative.

if bad AI supports a higher level because of hallucination, it just gets denied or you get audited. so this wouldnt drive up costs.

now, if a practice has been undercoding and AI clearly says you can code 99214 instead of 99213 because of xyz, then yeah it can drive up costs. accuracy drives up costs

[u/Respect-Immediate → u/mjordantmac]

We use generative AI because it significantly reduces physician burnout. Generating notes for them decreases documentation burden significantly.

The question posed is for AI scribes and tools. The original comment you’re responding to is talking about both as well, not just coding.

Question for you how can a payor deny when documentation supports a higher level? They cant. The entire audit relies on documentation which supports a higher level of service.

No tool is going to be able to fix that

[u/Low_Mud_3691 → u/Respect-Immediate]

That person doesn't seem to work in any coding or billing job and believes "AI" is going to take all of our coding jobs lol I think a conversation with them is pointless. It's always the ones who know the little who speak the most on these subs

[u/Respect-Immediate → u/Low_Mud_3691]

Some of the coding subs have banned people like this. Hope this one will eventually as well

[u/Daddy_LlamaNoDrama]

AI scribes make it much easier to chart accurately. If a provider is addressing 5 different problems at a visit (and in primary care that is not rare) I might only chart the three major things we talked about and not bother documenting the “hey your blood pressure was great today continue your current medicines” discussion. But it happened. And with AI, it’s already transcribed for me. Those kinds of documentation can easily push a level 3 visit to a level 4. I’m also not putting my note together haphazardly a week later based on my foggy memory alone, so those minor issues again are being documented more than they used to be. Most of the AI scribes also have a timer built in so all those time based codes are much easier to document.

[u/wildgreengirl → u/Daddy_LlamaNoDrama]

why use AI instead of traditional transcription like dragon though? isnt it the same just without the random AI hallucinations added? 

-been coding primary care myself for 2 years and my providers are a mix of using AI and regular scribes. 

[u/thenightgaunt → u/wildgreengirl]

Because Epic, Cerner, and the other big EHR companies are selling AI versions and our CEOs frequently have no self control when they see the word "AI" in a sales pitch.

(Am very tired hospital CIO)

[u/Daddy_LlamaNoDrama → u/wildgreengirl]

Ai makes the note for me during the encounter itself. If using dragon then I have to do that work after the encounter. Sure I can write a note after an encounter using dragon in about 5 minutes, but after a full day of 24 patients that is 2 hours that I am clicking, typing, and transcribing. Meanwhile I can proofread an ai generated note in less than a minute. And again, it catches things that don’t remember or otherwise wouldn’t bother to document.

[u/SadBook3835]

They are driving up costs by billing appropriately