How AI can solve healthcare's prior authorization problem


Prior authorization is a complex process by which payers determine the clinical appropriateness of procedures, prescriptions, and referrals. However, the current process is a significant drain on an already strained U.S. healthcare system costing between $23 and $31 billion a year. This is a big problem to tackle as it involves providers, payers, and patients.

Specifically, health plans are currently spending valuable time and resources manually reviewing authorizations, which is a time-consuming process that can delay treatments — or worse, be an obstacle to care. Not only this, but with manual reviews estimated costs between $20 to $50 per prior authorization clinical review.

This white paper outlines how payers can automate the prior authorization process to lower administrative burden and operational costs while enabling the delivery of faster, more efficient care.
 

Please fill out the form to download the whitepaper.