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AI use cases

AI use cases in healthcare

37 AI agents that healthcare companies run today, grouped by the team they work for. For each one: the process, what the AI does, where people step in and the result the company reported.

Customer service

In production

19k hours saved annually

Patient support with clinical routing

UK digital health provider

What the AI does
Answers delivery and platform questions and assigns medical queries to trained clinicians.
Where people step in
All medical queries go to clinicians.
Systems
Helpdesk

In production · reported 2025

72% decrease in AHT for routine requests

Appointments, refills and emergency call routing

US community health center

What the AI does
Greets patients 24/7, manages appointments and prescription refill requests in the EHR, detects emergencies and routes calls.
Where people step in
Identifies patients needing specialized help and escalates them.
Systems
Phone · EHR · Patient portal

In production · reported 2026

45% calls fully resolved

Inbound patient access call handling

US orthopedic practice

What the AI does
Answers every inbound call at the top of the IVR and handles scheduling, referrals and other requests 24/7.
Where people step in
Calls the agent does not fully resolve go to front-office staff.
Systems
IVR

In production · reported 2026

Intake days to 5-10 minutes

Patient intake, eligibility checks and scheduling handoff

US minimally invasive treatment provider

What the AI does
Creates a patient lead from a web form, extracts details from uploaded documents, checks coverage and copays with the insurer and alerts the care team.
Where people step in
Staff follow up by phone or email to schedule the first appointment.
Systems
CRM · Payer API · Slack/Teams · Web forms

In production · reported 2026

25,000+ HCP requests handled

Medical information responses to HCP inquiries

Japanese global biopharmaceutical company

What the AI does
Searches approved medical literature, finds evidence and drafts citation-backed responses to healthcare provider inquiries, capturing insights for reuse.
Where people step in
Medical information professionals review evidence, validate content and send the final response.
Systems
CRM · Document management · Integration platform

Sales

In production · reported 2025

74% call containment

Patient intake triage and FAQs

US addiction and mental health provider

What the AI does
Handles patient calls, collects patient information for enrollment and answers 40+ FAQs.
Where people step in
Staff focus on urgent cases and personalized treatment plans.
Systems
Phone · CRM

In production · reported 2025

100+ hours saved weekly

Member plan FAQs and case status

UK health plan provider, 2.5M members

What the AI does
Answers plan FAQs and case status questions from a rep-built knowledge base and drafts emails for reps.
Where people step in
Inquiries needing human support, especially from vulnerable members, go to a live rep.
Systems
CRM · Contact center · WhatsApp · Knowledge base

In production · reported 2026

Abandonment 46%→2%

Inbound call intake and warm handoff

US hearing care network

What the AI does
Collects caller name, phone and zip code, identifies intent and passes the call to a live agent with context.
Where people step in
All qualified calls go to live agents with context.
Systems
Phone · CRM

In production

~130% increase in attributed sales

Pre-purchase buyer questions at launch

US wearable fitness tech company

What the AI does
Answers prospective buyers' pre-purchase questions in a conversion-focused voice.
Where people step in
The sales team focuses on high-value leads.

Operations

In production

85% referrals completed autonomously

Faxed referral and order entry

US community health system

What the AI does
Reads inbound faxed referrals from three fax lines and transcribes and enters 14 order types, including MRI, CT and lab, into the EHR around the clock.
Where people step in
Only the most complex cases go to people for review.
Systems
Fax · Document management · EHR

In production

78% touchless registrations

Pre-visit patient registration

US physician-owned multispecialty clinic

What the AI does
Completes registration tasks in the EHR the way a staff member would, so patients register without staff work queues.
Where people step in
Staff handle the 22% of registrations that still need a touch.
Systems
EHR · Patient portal

In production

-90% order creation time

DME order intake from faxed packets

Family-owned US DME provider

What the AI does
Splits faxed packets into prescriptions, progress notes and sleep studies, classifies pages, routes work and creates patient and sales orders.
Where people step in
Staff keep about 2 minutes of active work per order, down from 20.
Systems
EHR · Portal · Fax

In production

75% reduction in time calculating bed capacity

Bed capacity and nurse staffing management

US health system, 23 hospitals

What the AI does
Provides real-time and projected bed demand for bed planning and matches unit demand forecasts to staff schedules to balance nursing.
Where people step in
Nurse managers make placement and staffing decisions using the projections.
Systems
Data platform

In production

90% reduction in clinical review time

Medical record summaries for clinical review

US clinical review services company

What the AI does
Ingests medical records, extracts relevant clinical data and generates structured draft summaries for clinicians.
Where people step in
Clinicians validate every summary.
Systems
Automation platform · LLM

Finance

In production

Month-end close 30 days → 4 days

Month-end close and invoice generation

Publicly traded US telehealth company

What the AI does
Posts entries, matches cash and deposits against AR, and turns a 30-40k-line billing file into ~200 invoices in ~5 minutes.
Where people step in
The finance team reviews and closes; subsidiary reporting is reviewed before the parent's SEC filing.
Systems
ERP · Spreadsheets

In production

300+ staff hours saved per month

Claim status follow-up with payers

US nonprofit regional health system

What the AI does
Checks claim status on payer portals, brings the details back into the EHR and flags which claims need escalation with the payer.
Where people step in
Staff focus on complex work that needs a human touch.
Systems
EHR · Portal

In production

-22% auth status work queue volume

Prior authorization status checks

US nonprofit regional health system

What the AI does
Checks authorization status across payers automatically, cutting items in the EHR authorization work queue.
Where people step in
Staff work the remaining queue items.
Systems
EHR · Payer portals

In production

Documents routed within 24 hours

Healthcare document classification and EHR routing

US revenue cycle management provider

What the AI does
Classifies incoming faxes and documents, decides whether each moves forward automatically or needs review, and places verified documents in the EHR.
Where people step in
Exceptions go to users for validation, edits or approval.
Systems
EHR · Document processing · Workflow orchestration

In production

25% efficiency improvement

Revenue cycle work orchestration

US revenue cycle management provider

What the AI does
Handles rules-based RCM work with robots and judgment-based scenarios with agents, and routes remaining work to people.
Where people step in
People handle exceptions and oversight; critical decisions go back to people.

Procurement

In production

$16M annual savings

Provider contract term extraction and decisioning

US Fortune 20 health insurer

What the AI does
Extracts rate terms, reimbursement methods, renewal and termination clauses and amendments from provider contracts into searchable data and ranks providers by actionability.
Where people step in
Subject-matter experts own contract term definitions and extraction logic.

In production

$50k+ invoice discrepancies identified per quarter

Invoice reconciliation against supplier contracts

Biotech and pharma company

What the AI does
Centralizes supplier communications and reconciles invoices against long-form manufacturing and research contracts.
Systems
Email

Supply chain

In production

98%+ touchless GL coding

Freight audit, GL coding and payments

US medical technology shipper

What the AI does
Audits freight invoices against configurable SOP rules, codes GL accounts without manual touch and runs scheduled payments that deliver a funding file to the ERP.
Where people step in
The operations team writes the SOPs the model learns from.
Systems
ERP

In production

$3.1M savings identified

Parcel invoice audit and fraud detection

Fortune 500 healthcare company, pharma unit

What the AI does
Ingests invoices and contracts in any format, standardizes the data, audits every package by tracking number and flags fraudulent or duplicate charges.
Systems
AP system · Carrier feeds

HR

In production

40% L1 capacity freed

Physician and employee IT and HR support

US acute-care physician partnership

What the AI does
Turns plain-language requests into actions, automating password resets, account provisioning and software access, with answers tailored by role, location and permissions.
Where people step in
The L1 help desk keeps the higher-priority work.
Systems
Slack/Teams · Helpdesk · Identity management · Knowledge base

In production

-83% placement management time

PACU patient flow and nurse staffing

US academic health system

What the AI does
Combines nurse schedules, census and surgery schedules, and uses predictive models to suggest staffing moves and patient placements.
Where people step in
Staff plan using the recommendations.
Systems
Data platform

In production

From 50 to 150 departments

Nurse and staff scheduling

Large US hospital operator

What the AI does
Balances staff schedules and competencies, including for future periods.
Systems
Scheduling system

IT

In production

40% L1 capacity freed

Physician and employee IT and HR support

US acute-care physician partnership

What the AI does
Turns plain-language requests into actions, automating password resets, account provisioning and software access, with answers tailored by role, location and permissions.
Where people step in
The L1 help desk keeps the higher-priority work.
Systems
Slack/Teams · Helpdesk · Identity management · Knowledge base

In production

Configuration tasks up to 10x faster

Platform configuration from plain-language requests

US life sciences consulting firm

What the AI does
Interprets configuration requests written in plain language, inspects the site configuration with read-only database queries and proposes a SQL script with an explanation.
Where people step in
Engineers review every proposed SQL change before it runs; the AI cannot execute changes.
Systems
Database

In production

Password-reset calls fell from 60% to 10%

Employee IT support

US health system

What the AI does
Resolves common IT issues such as password resets right away and speeds up approvals.
Systems
Slack/Teams · Helpdesk portal

Claims

In production

80%+ claims handled by AI

Medical claim form extraction and entry

US insurance claims clearing house

What the AI does
Reads often-handwritten CMS-1500 forms, extracts the data and enters it into the claims system.
Where people step in
Staff process the claims the agent does not handle, under 20%.
Systems
Claims system

In production · reported 2025

$100,000+/day prepayment savings identified

Prepayment claims editing for payment integrity

Large US national health plan

What the AI does
Ingests claims data, applies targeted edits and returns reason codes with explainable context before payment.
Where people step in
The plan decides how it responds to each edit.
Systems
Claims system

In production · reported 2025

71.4% task automation rate

Voice self-service for disability claim tasks

North American national health insurer

What the AI does
Guides claimants by phone through routine claim data collection, such as reporting surgery or confirming a return-to-work date.
Where people step in
Mid-call transfers lose form progress, so the assistant nudges callers to finish.
Systems
Phone

In production

8x faster claims processing

Insurance coverage validation for new patients

US mental health tech company

What the AI does
Batches validation tickets and triages them by state and insurer so they can be processed in parallel.
Where people step in
A human workforce performs the insurance validation.

Underwriting & risk

In production

200k+ cases/month with accelerated approval

Prior authorization decisioning

Fortune 20 US health insurer

What the AI does
Reviews prior authorization requests and medical records against clinical policies, then approves or escalates with step-by-step reasoning and source citations.
Where people step in
Escalated cases go to human review; clinical experts refine the AI's logic in plain language.
Systems
Medical record databases

In production

~$5.4M additional annually

Risk adjustment chart review before visits

US not-for-profit HMO

What the AI does
Reviews member charts before visits and surfaces suspected Hierarchical Condition Categories for providers to document at the point of care.
Where people step in
Providers review and document conditions at the point of care.

Anonymised summaries of public case studies published from 2023 to 2026. Company and vendor names are withheld. Figures are as the companies reported them; they are not Retexa results.

Questions

AI in healthcare

What are the most common AI use cases in healthcare?

In the 37 public cases we collected, AI agents in healthcare work mostly in customer service, operations and finance. Examples: patient support with clinical routing; appointments, refills and emergency call routing; inbound patient access call handling.

Where do people stay in the loop?

Each card says where people step in. In this industry, for example: all medical queries go to clinicians; identifies patients needing specialized help and escalates them.

Are these Retexa results?

No. These are anonymised summaries of public case studies from 2023 to 2026, with company and vendor names withheld. Figures are as the companies reported them. Retexa builds the same kind of agents on top of the systems you already run.

Other industries

More AI use cases

See every industry and team on one map

AI use cases in logistics and freight31 examplesAI use cases in banking and finance33 examplesAI use cases in insurance32 examplesAI use cases in telecom13 examplesAI use cases in retail and e-commerce30 examplesAI use cases in manufacturing33 examplesAI use cases in energy and utilities17 examplesAI use cases in travel and hospitality20 examplesAI use cases in real estate15 examplesAI use cases in government17 examplesAI use cases in software and SaaS35 examplesAI use cases in media and entertainment19 examplesAI use cases in automotive15 examplesAI use cases in consumer services21 examplesAI use cases in professional services26 examplesAI use cases in education9 examples

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