HomepageCase Study
Healthcare Payor
Deploying a decisioning system to accelerate the prior authorization approval process
Client
F50 Healthcare Payor
Timeframe
Deployed in production 1Q
Impact
$200M+
Forecasted Annual Savings with Distyl
$2B+
Annual Spend on Utilization Management
1000+
Complex Clinical Guidelines
Challenge
Insurers require prior authorization (PA) on certain procedures and prescriptions. Humans review these requests and compare them against evidence-based clinical policies. This review process is often manual, expensive, and time-consuming.
Solution
Distyl is building an AI decisioning system to review PA requests and their associated medical record data, compare them against clinical policies, and reason about them to make a decision to either approve the request or escalate it for human review.
The combination of Distyl’s platform and our business process automation primitives is enabling us to deliver a production-grade application
“When it comes to AI solutions, we could not be working with a better team than Distyl, and we can not wait to have them work on a number of other valuable opportunities”
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