Optum Launches AI Platform to Erase Prior Auth Friction

What You Should Know

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• The Launch: Optum is rolling out a dual-sided AI strategy to modernize prior authorization: Digital Auth Complete for providers (powered by Humata Health) and InterQual® Auth Accelerator for payers.
• The Provider Impact: By embedding AI directly into the EHR, the provider-side tool has demonstrated a 96% first-pass approval rate in early deployments, aiming to reclaim the average 13 hours per week staff spend on these tasks.
• The Payer Impact: The payer-side solution focuses on regulatory compliance (specifically CMS 0057), reducing review times by 56% while maintaining a strict “human-in-the-loop” policy that forbids AI from auto-denying coverage.

For health systems, the new offering is Digital Auth Complete. Powered by Humata Health, this tool embeds directly into the Electronic Health Record (EHR). The philosophy here is invisibility. “With Optum, our goal is to make prior authorization virtually invisible to providers and patients,” said Dr. Jeremy Friese, CEO of Humata Health.

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Read more at HIT Consultant here.