Patients are behind one of the latest applications of AI to the healthcare revenue cycle, and they are using it to review their bills.
Stories of consumers using ChatGPT or other generative AI tools to trim thousands from their medical bills by questioning charges are appearing in the news and social media. YahooFinance wrote about how a New York man who used generative AI tools to get a $195,000 bill trimmed to $37,000.
And according to a January report from Open AI, the company that owns ChatGPT, nearly 2 million messages per week on the platform focus on health insurance, including for comparing plans, understanding prices, handling claims and billing, eligibility and enrollment, and coverage and cost-sharing details.
“The rise of AI tools designed to negotiate medical bills reflects a growing gap between patients and the increasingly complex financial systems meant to support them, including confusing payer benefit designs and coverage rules,” said Shawn Stack, director of perspectives and analysis for HFMA.
Now, there are signs that ChatGPT is fielding healthcare questions from consumers at an accelerated rate. Three out of five U.S. adults lean into generative AI for health or healthcare in general, including to understand and manage their medical bills, according to OpenAI.
In this environment, healthcare revenue cycle leaders must consider: “How can we prepare our teams to respond to AI-driven inquiries about medical billing?”
Navigating the future of AI-driven medical billing conversations
Although health system revenue cycle leaders interviewed by HFMA for the February/March hfm cover story said their teams haven’t yet encountered ChatGPT-fueled billing inquiries, experts believe they’re likely to in 2026. In fact, one thought leader anticipates companies will commoditize this type of service for consumers. One potential angle: “Send us your bill and we’ll use AI to get you big savings.”
Here are three approaches healthcare revenue cycle teams should consider as consumers turn to ChatGPT for medical bill guidance.
- Double down on proactive patient financial communications. At a time when concerns about healthcare affordability and gaps in coverage due to policy changes are rising, taking a fresh look at how and when out-of-pocket estimates are shared is critical. “Payers and providers that invest in clear, compassionate and proactive financial conversations can reduce confusion, build trust and prevent third-party tools from stepping into a role that should be grounded in human understanding and patient support,” Stack said.
- Assess the accuracy of the estimates your organization provides. “Accurate patient billing is foundational to healthcare affordability, trust and financial sustainability,” said Richard L. Gundling, senior vice president, healthcare financial practices for HFMA. “When patients receive correct bills the first time, it strengthens confidence in both the care delivery system and the financing that supports it.”
- Boost your organization’s ability to identify patients who need financial assistance. Leading organizations automatically run presumptive eligibility checks, notifying patients of positive determinations afterward. Among patients, “It creates trust that probably wasn’t there before,” said Monument Health CFO Austin Willuweit, FHFMA, CPA, MPA. Pro tip: Make sure to notify patients when presumptive eligibility determinations are made.
