Google Cloud announced a new AI-enabled Claims Acceleration Suite that streamlines health insurance prior authorization and claims processing. The solution, leveraging the newly created Claims Data Activator, will help health plans and providers reduce administrative burdens and costs by converting unstructured data into structured data, enabling experts to make faster, more informed decisions that improve patient care. AI-enabled prior authorization is available to Google Cloud customers today, and other features of the Claims Acceleration Suite will be available later in the year.
The current prior authorization process takes 10 days on average, according to the Centers for Medicare & Medicaid Services (CMS). During this process, healthcare providers check the benefit coverage of their patients to see if prior authorization is required for a recommended procedure, medication or device, and submit the supporting information required. The health plan then receives and organizes this information for review by their physicians. The purpose of this process is to manage quality and to ensure members are receiving safe, necessary care. This results in both providers and payers investing significant resources because of the manual administrative intervention required.
Now with advanced technologies, what has been a heavily manual process can be modernized. Information being shared in unstructured formats, such as PDF documents converted from faxes, images and other health record data can be transformed into a structured format. Technology can significantly reduce time-consuming administrative prior authorization work, accelerating time-to-decision and access to care. Prior authorization contributes $25 billion in cost of care annually in the United States, and introducing more automation could save $454 million per year (Council for Affordable Quality Healthcare estimate), freeing up resources for providers and health plans to continue to advance their efforts in more direct care and care management programs.
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Google Cloud launches AI-enabled tool to help health insurance experts make faster prior authorization decisions.
“It’s time to modernize the prior authorization process, leverage current technology to improve access to care, and extract value to better serve the people in our communities,” said Amy Waldron, director, Global Health Plans Strategy and Solutions, Google Cloud. “Our Claims Acceleration Suite is a great example of Google Cloud’s AI driving much needed operational efficiencies by reducing the manual administrative work for providers; allowing payers to focus their time on clinical evaluation and review, improving speed to care; and extracting value from a process without disrupting the roles experts play in claims decisions.”
SOURCE: PR Newswire