San Jose, CA. October 17, 2023
OptraHEALTH announced the availability of its next-generation AI for providing personalized care cost estimations and automating the prior authorization process.
OptraHEALTH's patented technology, HealthGPT, leverages state-of-the-art Large Language Models (LLMs) transforming health insurance documents into deep knowledge-graphs and generating clinical intelligence. This clinical intelligence forms the basis of providing personalized cost estimations when combined with patient insurance data and the respective medical procedure/ test data. Thus, patients can now seamlessly understand costs that are personalized to them based on their insurance plans, all computed in real-time. Additionally, HealthGPT also supports Medicare/ Medicaid and direct pay options.
Healthcare organizations have noted an uptake in patients' interest in undergoing procedures and tests when provided with accurate personalized costs. However, the next step is to obtain prior authorization. HealthGPT is automating this complex task based on its clinical intelligence. HealthGPT prompts the patients to provide pertinent information required for the procedure/ test they plan to undertake and simultaneously informs providers about the clinical data points required for the prior authorization process. Previously this would require the providers to understand all aspects of the fine print, manually, and keep going back and forth with patients to gather the required data points which was erroneous and time-consuming. Now, HealthGPT understands such nuances and brings them to the attention of providers instantly and coordinates with patients. This is followed by automated PA docket generation and electronic submission. HealthGPT APIs integrate well with other software such as EMRs.
Dr. Gauri Naik, CEO, OptraHEALTH, expressed enthusiasm about this latest addition, stating, "Our commitment to advancing global healthcare is unwavering. By automating the personalized cost estimations and prior authorization process with clinical intelligence, we are not just streamlining workflows, but we are also empowering healthcare for tomorrow. This significant milestone aligns with our mission to deliver best-in-class clinical intelligence, ensuring that healthcare providers can focus more on critical tasks and less on administrative burdens."
As OptraHEALTH® continues to shape the future of healthcare through innovation, the automation of the prior authorization & cost estimation process stands as a testament to its dedication to providing solutions that enhance patient experiences, boost medical knowledge, and increase overall healthcare participation.
Media Inquiries Contacts: Ashwin Kotwaliwale MD Ph.D., Medical Director | OptraHEALTH | info@optrahealth.com
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