Healthcare
Your clinical and administrative teams bring expertise and compassion. AI brings comprehensive analysis and tireless consistency. Together, you deliver faster, more reliable patient care.
The Collaboration
Better Together in Healthcare
Healthcare requires both clinical judgment and administrative precision. Here's how AI supports both.
Complete Patient Context
AI reads the full patient record alongside current policy. Your team reviews with everything in one place.
Consistent Criteria Application
Same medical necessity standards applied every time. Reduced variance means fewer appeals and delays.
Faster Turnaround
What took days of back-and-forth now resolves in hours—with more thorough documentation, not less.
Appeal-Ready Records
Every decision documented with clinical rationale. If questions arise later, the reasoning is preserved.
A Day in the Life
Prior Authorization: Human + AI
See how authorization staff and AI work together on a treatment request.
Authorization Request Received
AI Handles
AI ingests patient record, insurance policy, treatment guidelines, and prior authorization history—cross-referencing all in seconds.
Staff Focuses On
Staff is notified with complete context already assembled.
Medical Necessity Analysis
AI Handles
AI maps diagnosis codes to treatment criteria, identifies supporting documentation, and flags any gaps in clinical evidence.
Staff Focuses On
Reviewer focuses on clinical judgment, not data hunting.
Policy Matching
AI Handles
AI identifies applicable coverage rules, exceptions, and step-therapy requirements. Highlights where this case differs from standard criteria.
Staff Focuses On
Staff reviews AI's policy interpretation, not raw policy documents.
Decision Package
AI Handles
AI prepares authorization recommendation with supporting evidence, alternative options, and appeal-ready documentation.
Staff Focuses On
Reviewer makes the final call with complete information.
Documentation & Next Steps
AI Handles
AI generates approval letter, updates systems, and schedules any required follow-ups. Full audit trail preserved.
Staff Focuses On
Patient gets faster answer. Staff moves to next case.
Total time: ~5 minutes with complete documentation
vs. days of back-and-forth between departments and payers
Applications
Where Teams Are Collaborating
Prior Authorization
AI synthesizes patient history, payer rules, and clinical guidelines. Reviewers make faster, better-documented decisions.
Eligibility Verification
AI checks coverage, deductibles, and network status across payers. Staff focuses on patient communication.
Clinical Documentation
AI drafts notes from encounter data. Clinicians review and refine, spending time on patient care.
Claims Processing
AI validates claims, identifies errors, and routes exceptions. Billers focus on complex cases.
Care Coordination
AI tracks referrals, follows up on appointments, and identifies care gaps. Coordinators handle patient relationships.
Quality Reporting
AI compiles quality metrics, validates data, and prepares submissions. Teams review and certify.
Important: AI supports administrative and documentation tasks. Clinical decisions remain with licensed healthcare professionals. All implementations comply with HIPAA and healthcare regulations.
See it in your healthcare workflow
Let's discuss how human-AI collaboration works for your organization's specific needs.