Could an artificial intelligence approach to prior authorization be more human?
Prior authorization (PA) may be a necessary evil within the healthcare system, contributing to physician burnout and delaying necessary care, but also allowing payers to prevent wasting resources on redundant, expensive, and/or ineffective care. PA has become an "informatics issue" with the rise of automated methods for PA review, championed in the Health Level 7 International's (HL7's) DaVinci Project. DaVinci proposes using rule-based methods to automate PA, a time-tested strategy [...]
Author(s): Lenert, Leslie A, Lane, Steven, Wehbe, Ramsey
DOI: 10.1093/jamia/ocad016