Our solution’s innovative approach:
Savings: By seamlessly integrating disease progression prediction into prior authorization decisions, our solution personalizes treatments, saving plans up to one-fifth of medical and administrative expenses within four months and automating up to 85% of decisions.
Time: Our agile infrastructure and generative AI-encoded payer policies allow for rapid integration without the need for sensitive information or payer data. Compared to industry standards, we are capable of launching a pilot up to nine months faster and reducing prior authorization time by up to eight days.
Explainability: Our platform’s platform's patented chatbot cross-references disease profiles and severity with relevant scientific literature, providing answers to member and provider queries about coverage decisions.
Accuracy: Our algorithm approves clinically appropriate care pathways, optimizing member outcomes.
Communication: Our platform reduces friction with auto-filled forms and real-time communication with providers through the chatbot feature.
The result is a transparent, efficient, and neutral platform that reduces administrative and medical expenses while improving member outcomes.