Has your health plan considered leveraging prior authorization to automatically launch care paths to improve outcomes for your members?
Care paths are built using a combination of widely accepted evidence-based clinical policy and historical patient cohort claims data, leveraged by AI and machine learning.
What does this look like for physicians?
When physicians submit authorization requests, intelligent prior authorization mines clinical attachments to match requests to:
- Care paths that are diagnosis-specific and evidence-based
- Patient cohorts categorized by clinical backgrounds and SDOH factors
From here, health plans evaluate service requests as a piece of a larger patient journey and can then use evidence to influence care further upstream.
Download our care path playbook to discover how care paths and other clinical innovations work together to improve physician collaboration and patient outcomes.
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