Question: I need a tool that can digitize and standardize prior authorization requests, integrating with electronic medical records and fax submissions.

To digitize and standardize prior authorization requests, integrate with electronic medical records and fax submissions, you might also want to take a look at Cohere Health. Its Cohere Unify platform is a suite of automation tools designed to modernize prior authorizations. That includes Intake, which digitizes prior authorization requests and integrates with EMRs and fax submissions, and Decisioning, which automates prior authorization decisions based on health plan-preferred policies. The result can be lower administrative costs, lower denial rates and better patient care and outcomes.

Another good option is Availity, an integrated provider engagement platform that streamlines administrative and clinical tasks. Availity offers AI-powered prior authorization tools and digital correspondence that can help automate prior authorization request processing and integrate with EMRs for a unified experience. Availity also can improve patient care by reducing waste and abrasion, improving operational excellence and enabling real-time collaboration.

Consensus is another good option that uses AI and NLP to convert unstructured documents into structured data. Its platform includes HIPAA-compliant digital cloud faxing, secure messaging and real-time health event notifications that can help reduce manual labor and improve operational efficiency when handling prior authorization requests. It ensures secure, accurate and timely exchange of information to improve patient outcomes and compliance.

If you're looking for a more general-purpose business process automation tool, ABBYY offers a digital transformation platform using AI, NLP and OCR. It's good at intelligent document processing and data extraction, so it's a good option for automating document-based processes like prior authorization requests. ABBYY's platform can handle documents in many formats and languages, providing fast and accurate insights to accelerate your workflow.