Most labs already have automation.

What they don't have is context.

Bolt-on AI and built-in AI solve different problems. One is the right place to start and the other is what breaks the ceiling. This paper is about knowing which is which before you sign anything.

Written for laboratory billing leaders, RCM directors, and lab executives at independent and specialty laboratories. About a 12-minute read.

What's Inside

One question, three decisions and the framework to make them.

The four capabilities behind every "AI" claim.

Three ways labs get this wrong.

A crawl, walk, run maturity model.

Six questions to ask any vendor.

$43B

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Spent by hospitals in 2025 trying to collect payments insurers already owed.

American Hospital Association, Costs of Caring 2026

70%

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Of denials are eventually overturned and paid. Most denial work is churn, not recovery.

Avality, 2026 Abrasion Index

25%

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Clinical laboratory vacancy rates in parts of the country.

Office of Rep. Jen Kiggans, Medical Laboratory Personnel Shortage Relief Act

63%/15%

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Of organizations use AI in the revenue cycle, and only 15% report positive ROI.

HFMA and FinThrive, 2026 Benchmarks

Four AI RCM Capabilities, in Plain Language

Vendor language has gotten loose. Knowing which capability a product has is most of the evaluation.

Most lab billing problems aren't effort problems, they're tooling problems. A system built for physician practices can't see what a lab loses. TELCOR RCM was built to find it.

CAPABILITY	WHAT IT DOES	IN A LAB, THAT LOOKS LIKE
Classification	Identifies what a document is and who it belongs to.	Sorting an inbound fax into a denial letter, audit request, or prior auth determination, and attaching it to the right patient and claim.
Extraction	Pulls structured facts out of unstructured clinical text.	Finding the supporting diagnosis inside a 40-page record when the req arrived with an ICD-10 code that won't pay.
Reasoning	Assembles an argument from assembled evidence.	Constructing a payer and patient-specific medical necessity argument for an appeal, citing the record it came from.
Orchestration	Takes the next action, and hands off to the next process.	An eligibility agent determining prior auth is required, then passing the case to a prior auth agent that builds and submits the packet.

Download

Bolt-On or Built-In: AI in Lab RCM

The full field perspective, from Sunjay Mouli, VP of AI Systems at TELCOR. About a 12-minute read, and six questions are worth bringing up to every vendor conversation you have.

The Real Problem

A lab has to articulate medical necessity from outside the provider-patient relationship. The hospital coder can go back to the chart. The lab usually cannot.

"Laboratory has all the complexity of having to articulate medical necessity, but sits removed from the traditional provider-patient relationship. That's what makes it especially tricky."

SUNJAY MOULI, VICE PRESIDENT, AI SYSTEMS, TELCOR

Or Start With Your Last 20 Denials

If you already know the answer and would rather not read nine pages to confirm it, we will run the self-check with you: what the wins depended on, where that information lived, and whether the gap is context or productivity.

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TELCOR: A Great Place to Work™

TELCOR customers see the value of choosing a vendor who has been recognized as a Great Place to Work. This prestigious certification is based on direct feedback from TELCOR employees, reflecting their positive workplace experiences. With decades of POC and RCM leadership, customers trust TELCOR for our transparency, responsiveness, and ability to turn complex processes into reliable measurable financial performance. It's not just software, it's a team committed to elevating every facility it serves.

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