North America — Healthcare Provider Network
North America Healthcare Provider Network partnered with Viston AI to reduce emergency department overload, improve clinical documentation quality, and lower claim denials through AI-powered triage, clinical summarization, and claims automation. The solution integrated directly with existing EHR systems and was deployed across seven hospitals to improve operational efficiency, patient experience, and revenue cycle performance.
Challenge
The healthcare provider network faced long emergency department triage wait times, increasing left-without-being-seen (LWBS) rates, and rising claim denials. Clinical teams struggled with fragmented documentation across multiple EHR modules, creating administrative burden, inconsistent records, and slower claims processing.
Solution
Viston AI conducted a discovery and data privacy assessment before implementing an AI-powered healthcare workflow platform. The solution included an AI triage assistant for symptom intake and acuity scoring, an LLM-based clinical summarization engine for structured SOAP notes and ICD-10 recommendations, and a claims coding assistant that identified missing documentation and automated CPT/ICD population. The platform integrated with Epic APIs, FHIR interfaces, and existing healthcare infrastructure while maintaining HIPAA-compliant workflows.
Results
28% reduction in triage wait time 12% reduction in claim denials 35% faster claim turnaround +18 NPS improvement in patient digital experience Average triage time reduced from 41 minutes to 29 minutes LWBS reduced from 5.2% to 3.7% Claim denial rate improved from 9.4% to 8.3% Claim processing turnaround reduced from 9.2 days to 6.0 days
AI Applications & Benefits
The project delivered three core AI capabilities. The AI Triage Assistant enabled nurse-facing symptom intake and acuity scoring to reduce triage delays and improve consistency. Clinical Summarization used large language models to generate structured SOAP notes and ICD-10 suggestions, reducing clinician documentation burden. The Claims Coding Assistant automatically identified missing documentation and suggested CPT/ICD codes, improving coding accuracy and accelerating reimbursement workflows.
Regulatory Compliance & Security
The solution was designed for healthcare-grade security and compliance. Controls included HIPAA compliance, SOC 2 practices, Business Associate Agreements (BAAs) with AI vendors, PHI de-identification using Presidio, prompt logging without PHI exposure, comprehensive audit trails, and explainable AI outputs for coding recommendations.
Technologies & Tools
The AI triage assistant gave us back clinician time while standardizing acuity scoring.
VP, Clinical Operations, Healthcare Provider Network
Project Details
2023
28 Weeks
$500K – $1m
12 people
