Streamlining Prior Authorization Insurance processes by leveraging real-time data integration and AI-driven predictions

The client faced multiple challenges in navigating fragmented payer systems and diverse insurance plans, which led to complications in prior authorization (PA) and benefits verification. High rejection rates, delays in PA approvals, and inefficient manual processes resulted in operational bottlenecks, increased costs, and non-compliance risks. Also, inconsistent PA success rates due to varying payer requirements and patient demographics compounded the need for scalable solutions to address the increasing complexity of multi-payer and multi-product patient support scenarios.