The debt-collection ecosystem will change as AI takes notes in exam rooms, codes visits and sends billing messages
Medical debt is expected to grow in coming years as Republican-led health cuts come into force this winter. As it does, a changing world of medical billing and debt collection awaits patients: one where artificial intelligence increasingly listens, codes, bills and collects.
Artificial intelligence takes notes in exam rooms, codes visits, sends out billing messages and powers AI agents who text patients in billing portals – all changing the debt-collection ecosystem.
Medical debt will grow among “both the insured and uninsured, because of how we’re increasingly putting more costs onto individuals for those plans”, said April Kuehnhoff, a senior attorney at the National Consumer Law Center.
“It’s people who lose their coverage because they can’t afford it, or they can’t meet these new stringent requirements. It’s people who maybe they can afford it but the plan they get isn’t as good, and they are asked to have a higher deductible, higher co-pay, so they just have a higher out-of-pocket [cost],” she said.
A report released last Tuesday found that more than one in four US adults reported they owed a medical debt in 2025. The proportion was the same – about one in four – for people with health insurance, according to an analysis by the Urban Institute and the Robert Wood Johnson Foundation.
AI company leaders, such as Anthropic’s Dario Amodei, have promised to cure all diseases in a decade. While scientists remain skeptical of those claims, financial analysts at JP Morgan have celebrated AI in coding, billing and collections as “early wins”.
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