Has AI-powered hospital billing inflated healthcare spending?

Driving the news‍

Health plans and providers are both turning to artificial intelligence to manage rising healthcare costs, and a recent Blue Cross Blue Shield Association report put fresh attention on AI-powered billing. CFO.com asked Cohere Health’s Lalithya Yerramilli about where AI can help most.

Why it matters‍

Healthcare costs keep growing, and technology on both sides can turn into AI “ping-pong” that creates friction, delays, and inaccurate, inconsistent payments.

Cohere Health's take‍

The goal is payment accuracy and getting patients to the right care faster.

• Cohere Unify™ can approve 85% of prior authorization requests in real time, easing provider burden and speeding up care decisions.
• Requests AI can’t determine in real time go to a human reviewer. AI never denies care requests or claims.
• Coding intensity is rising, and separating it from true patient complexity is a delicate challenge. Transparent, clinically grounded approaches can help plans validate coding and improve documentation quality.

The big picture

Plans and providers want the same thing: accurate payments and faster access to appropriate care. AI tools can support better documentation and better, clinically grounded validation. Transparent, domain-specific AI systems can help catch mismatches before payment without creating unnecessary provider friction.

Go deeper: Read the full story on CFO.com