Prior Authorization

Overview

• Delay in Patient necessary care due to Prior Authorization requests are taking time to validate
• Number of incoming requests got increased in the years.
• Manpower utilization.

Key Features & Functionality

• AI Driven extraction of Prior Auth Document to get the necessary details in system which required for validation.
• AI Driven extraction of criteria from the Policy Document, extraction of patient details and comparison of both policy and medical records.
• AI Driven summarization of records compared which enables user to validate the pre auth requests of ease.
• AI Driven document chat bot to get the details from required documents.

Benefits & Business Impact

• Automation of 65% manual tasks.
• Faster approvals due to process automations.
• Improved decision makings, leading to most accurate Prior Authorization approvals