Predict | Prior Authorizations

Streamline prior authorization and expedite access to care.

Administrative prior authorization (PA) processes have been estimated to contribute as much as $25 billion annually to total healthcare costs and can significantly delay care for patients. PA was designed to act as a patient-safety and cost-saving measure to ensure appropriate utilization management, but the massive administrative burden is taxing for both providers and payers.

BUILT FOR HEALTHCARE

Ingest, normalize, and blend data
from dozens of health data sources.

Electronic Health Records
Unstructured Clinical Notes
e-Prescribing Data
Vital Signs
Remote Monitoring Data
Medical Claims
Rx Claims
ADT Records
Lab Test Results
Social Needs Assessments
Social Determinants of Health (SDoH)
Operations & Services

Likelihood of prior authorization approval for alkylating agent prescription

HIGH RISK

Patient ID

Gender

Age

Risk Score Percentile

456382937

Female

77

95

Impact on risk

Contributing factor

Value

+27%

Diagnosis of Follicular Non-Hodgkin Lymphoma (12M)

Aug 2020

+23%

e-Rx for R-CHOP

Jun 2018

+17%

Procedure for Radiation Therapy (2)

Mar 2018

+11%

Procedure for Lymph Node Biopsy (12M)

Aug 2020

AI INFORMS ACTION

Pinpoint high-risk individuals and surface actionable risk factors.

ClosedLoop generates explainable predictions using thousands of auto-generated, clinically relevant contributing factors.

Accelerate

Accelerate patient access to approved treatment options

Automate

Automate the clinical review process for requests that are highly likely to be approved

Determine

Determine payer requirements and surface necessary patient data automatically

EXPLORE MORE USE CASES

Propensity to Pay

Payers

Providers

Predict propensity to pay and optimize collection.

Admission to a Skilled Nursing Facility

Payers

Providers

Predict SNF admission risk and reduce rehospitalization.

Rising Risk and Cost Bloomers

Payers

Providers

Identify rising risk individuals and improve outcomes.

Make AI/ML a core element of your care strategy.

Get in touch today to see the ClosedLoop platform in action.