Accelerating Pre-Authorisation Using AI
Our client, a top provider of prior authorisation services for US insurance companies, aimed to digitise manual processes with technology and AI, to decrease the overall processing timeline & eliminate human errors.
Overview
We partnered with our client to revolutionise the complex and cumbersome insurance pre-authorisation processes, a significant challenge for healthcare facilities, insurance providers, and patients.
With over a decade of industry expertise, our client identified the need to address manual work, delays, and errors through AI LLM technology.
Together, we aimed to streamline the entire pre-authorisation workflow, digitising processes and building an intelligent AI automation platform.
country
United States of America
industry
Medical Insurance
timeline
Oct 2023 - Ongoing
2x
Faster Decision Making
27%
Fewer Appointment Cancellations
70%
Reduction in Denied Pre-Authorizations
30%
Cost Savings
Transforming Workflow: Digitising the client's manual processes and AI implementation
We worked on
Product Development
The manual pre-authorisation process was digitized to reduce decision turnaround times and human errors. With Intuitive web interfaces and robust backend microservices technology, the platform was developed with capabilities for ease of use and transparency for all the stakeholders. The system was designed to be scalable to handle growing volumes of patient data seamlessly. End-to-end workflows were optimised to accelerate processing speeds and decision-making.
AI Integration
AI LLM was integrated throughout the platform to enable process automation and enhance accuracy. This integration speeds up the processing of information and validates it against guidelines, resulting in lower claim denial rates and improved accuracy enabled by AI.
Digital Documentation
The manual-driven pre-authorisation process was digitized by extracting data from E-fax forms through OCR. This eliminated the administrative workload previously required for manual data entry.
