Healthcare · AI Automation
Prior Authorization Packet Assembly
Guided prior-auth packet drafting in-VPC: ~35–45% less admin time on routine auths, humans on exceptions only.
The Problem
Clinical ops staff were assembling prior-auth packets from EHR notes, payer portals, and fax workflows: often multi-hour cycles that delayed care and burned clinician time.
The Solution
A guided automation layer that drafts payer-ready packets from approved EHR excerpts, flags missing documents, and escalates only exceptions to humans. PHI stays in the client's VPC; no training on patient data.
What we would do differently
Negotiate payer portal access before kickoff. Two payers without APIs forced a manual step we should have scoped as a known gap on day one.
Business Impact
Ops leaders got capacity back without hiring a new auth team. We sized outcomes as a range because payer mix and EHR maturity vary by site.
Healthcare AI industry pageTech Stack
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