By Jordan Armstrong, Chief Revenue Officer, ResultsCX
LinkedIn: Jordan Armstrong, MBA
LinkedIn: ResultsCX
Patient access is emerging as one of the biggest pressure points for health systems and a leading source of patient frustration. Long hold times, confusing check-ins, and opaque billing create friction at the very start of the care journey, eroding trust before treatment even begins.
Data shows that Americans spend the equivalent of a full workday each month coordinating care, with most finding the process complex and exhausting. A recent Congressional Research Service (CRS) report highlights a parallel challenge in price transparency: providers struggle to make complex data usable and available, creating confusion and inefficiency for patients.
These barriers to healthcare access do more than just inconvenience patients; they push costs higher across the system. Missed appointments, delayed treatments, unnecessary ER visits, and billing disputes all add up. Appointment no-shows alone cost the U.S. healthcare system an estimated $150 billion annually. That’s not all. Every negative experience increases the likelihood of disengagement, leading to poorer health outcomes.
For healthcare leaders, the question is clear: how do we create experiences that improve accessibility without overwhelming staff or budgets? AI, coupled with analytics, can be a game changer. By strategically applying these tools, health systems can move beyond incremental fixes to deliver access that is faster, smarter, and more human.
Reframing healthcare access
While many organizations have implemented access programs, outdated workflows, inconsistent agent training, and back-end inefficiencies continue to strain staff and frustrate patients. Here are four proven ways that AI and analytics can help health systems simplify, personalize, and scale care journeys to drive stronger outcomes across the board.
- Streamline and standardize patient access workflows to minimize delays and confusion
Administrative costs account for roughly one-quarter to one-third of U.S. healthcare spending, an enormous drain on resources that could otherwise support direct patient care. For payers, an effective way to address this imbalance is by automating patient access workflows, including appointment scheduling, patient registration, and prior authorizations.
As an example, the administrative weight of manual prior authorizations translates into lost time, disrupted care continuity, and mounting financial strain for physicians. For patients, it can mean uncertainty, frustration, and, in too many cases, adverse outcomes. According to surveys, 94% of patients experience care delays, and 78% abandon treatment altogether.
AI and automation with humans at the helm can streamline processes, cut errors, and accelerate approvals. It helps healthcare organizations overcome major pain points, including agents spending valuable time checking payer portals, denials from outdated insurance data, and fragmented payer communications across multiple systems.
- Automate routine agent tasks and surface the right information
By automating routine administrative tasks like appointment scheduling, insurance verification, and referrals, AI-powered workflows eliminate the need for manual follow-ups and back-end billing, reducing errors and rework. Meanwhile, chatbots put the right insights at agents’ fingertips and recommend next-best actions, while efficiently handling routine tasks like after-call notetaking. Thanks to AI-powered knowledge bases, agents spend less time searching for information and more time engaging with patients, resulting in smoother check-in and registration and happier, more engaged front office staff.
- Strengthen training and coaching for confident, consistent service
AI-driven simulation and intent-based training are gaining traction in healthcare and other regulated industries. While AI can replicate scenarios, it cannot teach empathy or the human connection that makes interactions feel authentic. This can make conversations sound mechanical, leaving agents struggling to balance accuracy with compassion. The challenge is to create training that equips agents with both technical skill and human sensitivity.
That’s where persona-based training comes in. By combining simulation with adaptive personas using data and AI to mimic customer types, agents can practice real-world scenarios while learning to respond to different needs dynamically. This approach makes training more engaging, personal, and effective—building skills in empathy, confidence, and decision-making. The result: agents who can relate to callers, ask meaningful questions, and deliver the experience customers truly deserve.
- Give patients clear, upfront information to minimize billing surprises and improve collections
Eligibility verification has long been one of healthcare’s most manual and error-prone processes, which slows down care delivery, drives claim rejections, and strains administrative staff already burdened by shifting policies and coverage rules. Automation is changing that equation. Leveraging AI and RPA, providers can now access, retrieve, and analyze coverage data across multiple sources in real time, enabling healthcare staff to provide accurate, upfront estimates. Predictive insights can also identify patients at risk of non-payment, allowing providers to offer flexible plans and multiple payment options for increased convenience. This shift leads to fewer billing surprises, stronger patient trust, and improved collection rates that benefit both patients and healthcare organizations.
Modernizing healthcare’s front door
Patients today expect experiences on par with leading consumer brands, but with the added weight of trust, privacy, and life-altering decisions. Meeting these expectations requires a clear action plan: reduce friction, enhance transparency, and design journeys that align patient well-being with organizational sustainability. AI and analytics make this possible, delivering measurable value by lowering costs, protecting revenue, and building the trust and loyalty that drive long-term success.