Prior auth done better with generative AI
Prior authorizations are the second most time-consuming RCM task. But, with generative AI (GenAI), they don't have to be. AKASA Authorization Management can help you reduce auth delays, enable timely patient care, and ease staff burden.
With AKASA Authorization Management, GenAI powers your patient access workflows and team
Authorization Advisor
Authorization Advisor is a new GenAI assistant that helps prior authorization specialists efficiently and comprehensively complete authorization submissions. It provides staff — from entry-level to veteran — with an interactive sidebar view of patient details and curated clinical documentation from the EHR, all directly in their workflow. In addition, it supports any payer portal or service line, and most EHRs.
How Authorization Advisor works
Authorization Advisor gives patient access staff superpowers. With this nimble tool, everything is right in their workflows so they can work both better and faster.
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EXTRACTS AND PRESENTS
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REVIEWS AND SUGGESTS
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APPROVES AND SUBMITS
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LEARNS AND IMPROVES
Authorization Advisor efficiently extracts and presents key information from the EHR. It connects to the EHR via a standards-based integration to access the data needed and supports additional data sources (like scanned docs). Then it presents those details in a convenient interactive sidebar on the payer portal.
Using our powerful GenAI technology, Authorization Advisor comprehensively reviews all relevant medical information and recommends documents to include in auth requests, along with evidence-based justifications. The technology then pulls those suggestions into the sidebar for the RCM team to evaluate.
The solution rapidly populates the patient details into the auth submission on the payer portal. It eliminates the need to toggle back and forth between screens — everything is right there. Staff then reviews Authorization Advisor's proposals for clinical documents in the sidebar, selecting and attaching the appropriate ones. Finally, they submit the auth, recording the response details in the EHR.
Our technology continuously learns from documents the prior auth specialists select and what answers they choose on the auth form. The AI uses all of this knowledge to improve how it operates and the suggestions it makes.
Why AKASA Authorization Advisor
This product will help your team, patients, and processes by:
- Empowering prior auth specialists with critical information at their fingertips
- Improving auth request comprehensiveness by helping your staff attach the right documentation the first time
- Maximizing productivity by enabling your staff to submit auth requests easily
- Reducing physician and clinician time for peer-to-peer reviews and answering payer clinical questionnaires
- Enabling timely patient care by securing prior authorization approvals further in advance
I’ve been using Authorization Advisor to submit auths and it’s spectacular. It does the heavy lifting of reviewing and presenting the documents I need to complete the auth. Plus, it brings patient information right to the payer portal, right into my workflow. No more jumping back and forth between the EHR and portal or worrying about screens freezing and losing all my work. Authorization Advisor has saved me so much time. I wish this tool existed years ago.
— Authorization Advisor user
Bring the power of generative AI to revenue cycle staff fingertips with Authorization Advisor
Authorization Automation
If you want to remove work from your staff's plate, AKASA Authorization Automation can help. Our Authorization Submission and Authorization Status products holistically address prior authorization with automation. Through our unique AI + experts-in-the-loop approach, AKASA determines if prior auth is required, gathers the necessary information, uses GenAI to intelligently review and attach clinical documentation, submits the auth request, checks on the status of those requests, and documents the results. This means more timely patient care and fewer staff frustrations.
How Authorization Automation works
We're automating the complex and time-consuming work of submitting authorizations and checking their status with AI-powered automation and our revenue cycle experts. Your staff can then focus on more critical tasks.
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AUTHORIZATION SUBMISSION
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AUTHORIZATION STATUS
Our automation validates if an auth is required and then fills out the auth requests on payer portals — including supplemental diagnosis and procedure codes and required medical records. Unlike other tools, we leverage GenAI to comprehensively review all relevant medical information, finding clinical documents a human may miss and suggesting relevant ones. This workflow also determines if an auth is not required and documents that in the EHR. We ensure your auths are thorough and accurate in order to improve turnaround time.
Our technology obtains well-timed auth statuses for pending auth requests. It returns detailed information to drive follow-up workflows and documents the claim with approved, pending, or denied status and portal screenshots.
Why AKASA Authorization Automation
Ease staff burden
Free your staff from tedious and frustrating prior authorization tasks so they can focus on more complex and revenue-generating concerns.
Obtain more auths
Reduce delays by completing a higher volume per day with less effort due to automation. Shift your team to working same-day/next-day tasks and complex service areas.
Improve auth quality
Automate the process of reviewing, attaching, and submitting the most relevant clinical documentation. The result: Auths that are correct and complete — the first time.
22%
reduction in auth work queue volume
At Montage Health, we want to be at the forefront of healthcare automation. AKASA is helping with that. Using automation for prior auth has improved our efficiency. We’ve been able to grow and add new services without overburdening our staff. I love automated authorization checks.
Matt Morgan
CFO, Montage Health
Explore other AKASA solutions
The AKASA Platform
Superpowers for your revenue cycle
Our platform integrates advanced generative AI with our deep revenue cycle expertise. By training our models on clinical and financial data, we’re bringing you accuracy, speed, and completeness. And driving more revenue for your organization.
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