Microsoft Launches AI Tool to Improve Financial Health of Rural Hospitals

The tool is available through GitHub and provides actionable recommendations for billing staff while learning from their feedback to enhance claim resolutions.

Microsoft has launched the claims denial navigator, an AI-powered tool designed to help rural hospitals manage denied insurance claims and improve revenue collection.

The tool is available through GitHub and provides actionable recommendations for billing staff while learning from their feedback to enhance claim resolutions.

Denied claims are a major financial hurdle for smaller hospitals, with the average cost of managing denials reaching USD 330,000 annually. Rural hospitals face an 18% denial rate, compared with 10% in urban hospitals, slowing cash flow and increasing administrative costs. The claims denial navigator streamlines resolution for Medicare, Medicaid, and commercial claims without transferring hospital data externally.

Scott McEachern, CIO of Southern Coos Hospital & Health Center in Oregon, said, “Our revenue cycle team leveraged the denial management app to support the transition to a new electronic health record system, reducing the legacy rundown timeline by several months. Participation in the RHAIL program also demonstrated the value of developing low-cost, targeted applications in key operational areas like revenue cycle.”

Dr. Jim Weinstein, Senior VP at Microsoft Health—Innovation, added, “After decades of working to improve healthcare access and equity, I’ve seen how systemic financial pressures threaten the survival of rural hospitals. The claims denial navigator represents a critical step forward—an AI-powered tool that empowers rural providers to recover revenue more efficiently, strengthen their financial footing, and continue delivering essential care to their communities.”

Microsoft is partnering with the Texas Office of Rural Clinics and Hospitals (TORCH) and the Washington State Hospital Association to facilitate deployment and track outcomes. Consulting partner Slalom will support broader adoption through its Public and Social Impact team.

The tool is part of Microsoft’s Rural Health Resilience Program and Rural Health AI Innovation Lab (RHAIL), which aims to strengthen financial stability and equitable access to healthcare in rural communities.

Stay tuned for more such updates on Digital Health News