Regional health system with 15 hospitals processing 200K+ prior authorization requests annually with 72-hour average turnaround and $25M administrative costs.
Architecture Solutions Delivered​
Intelligent Prior Auth Engine
AI-powered clinical note analysis, policy matching, auto-approval for routine cases
Clinical Decision Support
Evidence-based treatment protocols and guideline compliance validation
Payer Integration Platform
Real-time eligibility checks, automated submission to payers, status tracking
GenAI Documentation Assistant
Generates clinical justification narratives and identifies supporting evidence
Analytics Dashboard
Authorization trends, denial patterns, and revenue cycle impact analysis