Prior authorization (PA) and utilization management (UM) practices can be key drivers of member retention and satisfaction and are a significant opportunity to differentiate your plan in the market. At PINC AI™ Stanson, we are focused on tackling the hardest part—the complex medical necessity reviews that can be time consuming and an expensive process for your nurses and physicians. We can help adopt a clinically focused artificial intelligence (AI) solution in a way that can dramatically improve your UM processes and automates your prior authorization, all while gaining the trust of your clinicians and utilization management team. It’s time to demand near-instant approval and proof of every decision with ReviewAssist.
ReviewAssist can help validate a patient’s eligibility and clinical necessity without delaying care.
REAL-TIME MEDICAL NECESSITY DETERMINATION
Stanson can help increase UM throughput and lower overall expenses by automating medical necessity determination using AI, natural language processing (NLP) and machine learning (ML) to minimize the need for human review on basic submissions and helping to only allocate human review for the most complex cases.
Near-Instant Approval with ReviewAssist
Help validate a patient’s eligibility and clinical necessity without delaying care.
Smart, Innovative AI
Use artificial intelligence (AI), natural language processing (NLP) and machine learning (ML) for fact extraction and rule-based adjudication that can be approved with provenance or proof of why the AI approved the request.
Show Your Work Approach
The AI will show its work or provide proof and a transparent decision trail for auditing purposes that can be both clinically and legally defensible.
Annual Spend Reduction
Help reduce administrative expenses and your per member per month (PMPM).
Full-Service Radiology Benefit Management (RBM) with ImagingAssure
Need help on those complex cases that require human review? ImagingAssure offers RBM services with our very own radiologists on staff to help guide ordering physicians for the best possible outcomes and is accredited by Utilization Review Accreditation Commission (URAC).
How Payers and Providers Can Simplify the Prior Authorization Process with PINC AI™ Stanson Technology
The PINC AI™ Stanson PA solutions use machine learning (ML), and clinician codified and validated PA policies to automate the manual process, which can reduce the wait time from days to less than a minute.
How Long Prior Authorization Timelines Impact Payer CFOs
The harm to patients from long prior authorization wait times is well documented, but patients are not the only ones who would benefit from shortening the time for prior authorizations.
E-book: Automated Electronic Prior Authorization for Patients, Providers and Payers
The on-demand generation can have an instant prior authorization process that rivals the ease of use of their rideshare, food ordering and movie streaming apps that makes their lives more enjoyable and productive.
Improve Member Experience and Retention
Automated Medical Necessity Reviews
Guidance at the Point of Approval
Use EHR Data to Transform Prior Authorization from ‘Mother May I’ to Real-Time CDS
Clinical Decision Support (CDS) and artificial intelligence (AI) can help solve the challenges of PA, and Stanson Health offers a tech enabled service that automate and simplifies PA with our radiology benefit management (RBM) solution for both providers and payers.