Owensboro (Ky.) Health is piloting an AI platform developed by Optum and Microsoft that aims to tackle one of the most persistent sources of clinician frustration: the administrative complexity of documentation, coding and claims.
For leaders at the health system, the project is less about adopting new technology and more about reducing the operational friction that shapes everyday clinical workflows.
“One of the biggest things we always look for as providers is what we can do to ease workflow, increase efficiency and decrease burnout,” Bridget Burshears, MD, chief medical information officer, told Becker’s. “How do we remove the pebbles that make workflows more difficult for clinicians?”
The pilot centers on Optum Real, a claims platform designed to bring clinical documentation, coding and reimbursement processes closer to the point of care. The technology combines Optum’s healthcare data and payer expertise with Microsoft’s AI and cloud infrastructure, including tools that can capture and analyze clinical conversations in real time.
One challenge the pilot aims to address is the disconnect between clinical care and the administrative systems that translate that care into billing and reimbursement.
“We’re trained very well in medicine, but we’re not trained very well in the business of medicine,” Dr. Burshears said. “Sometimes the care is provided, but it isn’t documented in a way that reflects that.”
The pilot aims to reduce that disconnect by embedding AI-powered prompts directly into clinical workflows. During a patient encounter, ambient technology can capture the conversation between the clinician and patient and generate documentation in real time. The system can then identify potential documentation gaps that could affect coding or reimbursement.
For example, if a physician performs a procedure but omits a detail that determines the billing level — such as the length of a wound when placing sutures — the system can flag the missing information and prompt the clinician to add it before the visit ends.
“When documentation isn’t complete, those charts get sent back to the provider multiple times,” Dr. Burshears said. “That creates a lot of messages in the EHR inbox and increases workload.”
Dr. Burshears added that addressing those gaps early with this tool could help prevent that. The broader goal of the initiative is to compress a claims process that often unfolds over weeks into something that happens much closer to the clinical encounter.
When a clinician completes documentation after a patient visit, the charts are then reviewed by coding teams, submitted to clearinghouses and ultimately sent to payers. Claims that contain errors or incomplete information are returned, restarting the process.
The result is a cycle of manual review and resubmission that can stretch reimbursement timelines and create significant administrative work.
Optum leaders involved in the project said the new approach aims to collapse much of that workflow into real time by combining ambient documentation with coding intelligence and payer rules.
In the envisioned model, the system can analyze documentation as it is created, automatically generate coding and billing information and validate the claim against payer requirements before it is submitted. Providers could know what they will be reimbursed for a visit much earlier, while patients could gain clearer insight into their financial responsibility before leaving the clinic.
That transparency could also help address patient collections, which remain a major financial challenge for health systems. A significant portion of patient financial responsibility goes unpaid each year, in part because costs are often unclear until long after the visit occurs.
The Owensboro Health pilot is still in its early stages, and leaders said they are continuing to gather feedback from clinicians as the technology is implemented.
And, as with any AI deployment in healthcare, governance and oversight are a central focus. To that end, the health system has established a committee to review AI tools and evaluate them across a range of factors, including safety, performance and alignment with clinical standards.
The committee works alongside broader governance processes developed by Optum to evaluate issues such as bias, model drift and consistency in AI outputs.
Leaders said that collaboration between the health system and technology companies has been critical to shaping the pilot.
“Working directly with clinicians helps ensure we’re designing something that reflects how medicine is actually practiced,” an Optum leader said.
For Owensboro Health clinicians, the promise of the technology lies in its ability to reduce the cognitive load that administrative requirements place on providers.
For years, many digital health tools have added new steps and clicks to the clinical workflow. Dr. Burshears said the current wave of AI technologies may finally begin reversing that trend.
“In the past, new technology often meant more work for providers,” Dr. Burshears said. “Now we’re starting to see technology that gives them time back with their patients.”
For clinicians who entered medicine to focus on patient care, that shift is significant.
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