Question: Are there any digital solutions that can streamline prior authorization requirements for medical expenses and patient care?

Cohere Health offers Cohere Unify, a full utilization management platform that can help streamline prior authorization. The platform includes automation tools like Intake, Decisioning, Review, Optimization, and Transformation that can automate prior authorization requests, automate decision-making, help clinical reviewers, and improve patient outcomes. The platform can benefit health plans and providers by reducing administrative costs, lowering denial rates, and getting patients access to care faster.

Another great option is Availity, an integrated provider engagement platform with AI-powered prior authorization capabilities. Availity's platform streamlines administrative and clinical workflows to reduce waste and improve patient care. It includes automated solutions for pre-service, post-service, and post-adjudication phases, as well as denial prevention and management tools, all of which can help streamline prior authorization and get patients access to care faster.

Smart Data Solutions also offers powerful healthcare workflow automation tools that can handle many aspects of prior authorization. The suite includes Digital Mailroom, Data Capture, Claims Operations, Clearinghouse, Interoperability, and Prior Authorization, all designed to improve claims quality and speed, reduce costs, and increase process efficiency. These tools use AI and automation to provide high accuracy and scalability, making operations easier to manage and reducing the workload on healthcare providers.