from pilot to scale: making agentic artificial intelligence work in health care

ensemble describes a neuro-symbolic approach that grounds large language models in clinical logic and structured data to scale agentic artificial intelligence across hospital revenue operations.

over two decades of building advanced systems shaped ensemble´s view that prompt-based large language model deployments are insufficient for regulated domains like health care. the company pursues a neuro-symbolic artificial intelligence framework that pairs fine-tuned LLMs and reinforcement learning with symbolic knowledge bases and clinical logic. this hybrid architecture is intended to reduce hallucinations, expand reasoning, and ensure decisions are anchored to enforceable guidelines through an in-house incubator that pairs elite researchers with health-care experts.

ensemble’s agentic artificial intelligence strategy rests on three pillars. first, high-fidelity data sets: the company has harmonized more than 2 petabytes of longitudinal claims data, 80,000 denial audit letters, and 80 million annual transactions mapped across roughly 600 steps of revenue operations to fuel its end-to-end intelligence engine, EIQ. second, collaborative domain expertise: AI scientists work directly with revenue cycle managers, clinical ontologists, and labeling teams while embedded end users provide post-deployment feedback for rapid iteration. third, elite AI scientists: the incubator includes PhD and MS talent from institutions such as Columbia University and Carnegie Mellon University and experience from FAANG companies, combined with access to sensitive health data and infrastructure to test novel research in a mission-driven setting.

the approach is already in production and pilot across several use cases. for clinical reasoning, guidelines are rewritten into proprietary symbolic language, patient records are parsed into that language, and deterministic matches produce evidence-grounded appeal letters, improving denial overturn rates by 15% or more. pilots include utilization management and documentation improvement. a multi-agent reasoning pilot coordinates autonomous agents to interpret accounts, retrieve data, and escalate complex cases to humans to accelerate reimbursement. conversational agents handle inbound patient calls, with operator assistants delivering transcriptions and suggested actions; ensemble reports a 35% reduction in call duration and a 15% improvement in patient satisfaction. ensemble frames this work as a rigorous, responsible path to scalable artificial intelligence in health care.

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