Prior authorization drafting for payer-side utilization management
- Problem
- Payer UM teams manually assemble evidence packets against medical-policy criteria for thousands of requests per week — slow, costly, and inconsistent.
- Solution
- A Prior-Auth Drafting Agent that ingests the request, retrieves the applicable medical policy, assembles a cited recommendation packet, and routes it to a clinical reviewer.
- Outcome
- 50%+ reduction in packet-assembly time, with every recommendation carrying source citations back to policy paragraphs.
