Can GPT Improve the State of Prior Authorization via Guideline Based Automated Question Answering?

arXiv:2402.18419v1 Announce Type: cross
Abstract: Health insurance companies have a defined process called prior authorization (PA) which is a health plan cost-control process that requires doctors and other healthcare professionals to get clearance in advance from a health plan before performing a particular procedure on a patient in order to be eligible for payment coverage. For health insurance companies, approving PA requests for patients in the medical domain is a time-consuming and challenging task. One of those key challenges is …

abstract advance arxiv authorization automated companies control cost cs.ai cs.cl cs.lg doctors gpt health healthcare insurance prior process professionals question question answering state type via