AI Playbook
for Hospital & Health System Administrators

• CFOs, controllers, and finance teams
• Revenue cycle, denials, and managed care leaders
• Supply chain and purchasing leaders
• Workforce, HR, and labor finance teams
• Grants, compliance, and administrative leaders at hospitals and community health centers

• Start with: monthly variance narrative or finance committee report
• Save as a skill: variance method and report format
• Connect: aggregate financial exports
• First agent: monthly variance narrative drafter
• Measure: reporting days, edits

• Start with: supply spend analysis
• Save as a skill: spend and contract rules
• Connect: PO and contract data
• First agent: off-contract spend monitor
• Measure: contract compliance, savings

# DNFB & KPI Watch

## Job to be done
Keep cash flowing by spotting revenue cycle bottlenecks.

## When it runs
Daily for DNFB; weekly for KPIs.

## Approved context
DNFB by hold reason, revenue cycle KPIs.

## Operating loop
Summarize DNFB by reason and age; flag KPI drift; assign owners.

## What it delivers
A revenue cycle status report.

## Human owner
Revenue cycle director.

## What it must never do
Never touch accounts, codes, or documentation.

## How to measure it
DNFB dollars, days in AR, clean claim rate.

## Operating rules
1. Use only approved sources and follow the linked health system skill.
2. Cite report, claim, or record IDs and separate facts from assumptions.
3. Route compliance questions, PHI exposure risks, and material variances to the human owner immediately.
4. Keep an audit record of trigger, inputs, output, reviewer, decision, and override.
5. Stop and ask for human review when regulation, contract terms, or approval authority are unclear.
6. Never process PHI outside tools approved under a BAA by your privacy officer.

# Off-Contract Spend Monitor

## Job to be done
Keep purchasing on contract and on price.

## When it runs
Weekly.

## Approved context
PO and invoice data, contract prices.

## Operating loop
Flag off-contract and price-variance purchases; summarize by department and category.

## What it delivers
A spend exception report.

## Human owner
Supply chain director.

## What it must never do
Never place or cancel orders.

## How to measure it
Contract compliance %, price variance dollars.

## Operating rules
1. Use only approved sources and follow the linked health system skill.
2. Cite report, claim, or record IDs and separate facts from assumptions.
3. Route compliance questions, PHI exposure risks, and material variances to the human owner immediately.
4. Keep an audit record of trigger, inputs, output, reviewer, decision, and override.
5. Stop and ask for human review when regulation, contract terms, or approval authority are unclear.
6. Never process PHI outside tools approved under a BAA by your privacy officer.

# Grant Deadline & Burn Rate Monitor

## Job to be done
Never miss a grant report and keep spending on plan.

## When it runs
Weekly; 45 days before report deadlines.

## Approved context
Award tracker, budgets, expenditures.

## Operating loop
Track deadlines; compute burn vs. time; draft report outlines with [NEEDED] flags.

## What it delivers
A grants status report.

## Human owner
Grants manager.

## What it must never do
Never submit reports or draw funds.

## How to measure it
On-time reports, unspent balances.

## Operating rules
1. Use only approved sources and follow the linked health system skill.
2. Cite report, claim, or record IDs and separate facts from assumptions.
3. Route compliance questions, PHI exposure risks, and material variances to the human owner immediately.
4. Keep an audit record of trigger, inputs, output, reviewer, decision, and override.
5. Stop and ask for human review when regulation, contract terms, or approval authority are unclear.
6. Never process PHI outside tools approved under a BAA by your privacy officer.

# AI Use Case Intake Reviewer

## Job to be done
Give the AI governance committee consistent, scored requests.

## When it runs
When a new AI use case is submitted.

## Approved context
Use case requests, criteria, data classifications, vendor info.

## Operating loop
Score requests; list data and oversight questions; check BAA status.

## What it delivers
A scored intake packet.

## Human owner
AI governance committee.

## What it must never do
Never approve use cases or enable tools.

## How to measure it
Time to decision, approved pilots, incidents.

## Operating rules
1. Use only approved sources and follow the linked health system skill.
2. Cite report, claim, or record IDs and separate facts from assumptions.
3. Route compliance questions, PHI exposure risks, and material variances to the human owner immediately.
4. Keep an audit record of trigger, inputs, output, reviewer, decision, and override.
5. Stop and ask for human review when regulation, contract terms, or approval authority are unclear.
6. Never process PHI outside tools approved under a BAA by your privacy officer.

• What AI does: Volume, rate, and efficiency variances
• Helps: Faster, clearer reporting
• Control: Leaders confirm causes

• What AI does: DRG cost drivers
• Helps: Target opportunities
• Control: Clinical leaders interpret

• What AI does: Preventable denials by owner
• Helps: Fix front-end causes
• Control: Consistent mapping

• What AI does: NCD/LCD requirements
• Helps: Fewer medical necessity denials
• Control: Compliance interprets

• What AI does: Off-contract and price variance
• Helps: Quick savings
• Control: Value analysis for clinical items

• What AI does: Shortage risk and substitutes
• Helps: Prevent disruptions
• Control: Clinical leaders approve substitutes

• What AI does: Hours per unit of service vs. target
• Helps: Staff to demand
• Control: Targets reflect acuity

• What AI does: Patterns by role and manager
• Helps: Retention
• Control: Stay interviews

• What AI does: One-page fit and requirements
• Helps: Faster go/no-go
• Control: Read full announcement

• What AI does: Spending vs. time
• Helps: Avoid overruns
• Control: Program leads confirm

• What AI does: Metrics, risks, and decisions
• Helps: Better governance
• Control: Controller verifies

• What AI does: Plain-language briefs
• Helps: Informed trustees
• Control: Verify current policy

• Ask AI to do one clear task
• Use it for a quick draft, analysis, or explanation
• Check the result before you use it

• Run a skill on a schedule or when something happens
• Gather the information, prepare the work, and flag issues
• Leave coding, clinical, staffing, and financial decisions with people

• Variance narratives and forecasts
• Cost report preparation
• Cost per case analysis
• Board finance reports

Claude, ChatGPT, Gemini, and Copilot write, summarize, and follow instructions.

In a health system: variance narratives, board reports, policy drafts, grant narratives.

Compares records to rules and flags exceptions.

In a health system: payments vs. contracts, purchases vs. GPO prices.

• No PHI in tools without a BAA and approval
• Default to aggregate and de-identified data
• Minimum necessary in every export
• Privacy officer approves exceptions

• Financial assistance publicized and applied
• EMTALA always respected
• Collection actions follow rules
• Plain-language communication