Source/disclosure information
Disclosure:
Davis is Senior Vice President and Chief Information Officer for Blue Shield of California. Healio said at the time of publication he was unable to verify Pandita’s relevant financial disclosures.
Important points:
- Google said its technology reduces administrative burden while enhancing patient care.
- The AI-enabled suite is now available for Google Cloud customers. More features will be available later this year.
Google Cloud has announced an artificial intelligence-powered Claims Acceleration Suite to help streamline pre-authorization and claims processing, the company announced in a press release.
The suite uses software from Google’s Claims Data Activator to transform unstructured data into structured data, enabling insurers to make faster decisions and improve patient care, according to the release. . It also utilizes several analytical reporting tools for machine learning and data visualization.
AI-powered preauthentication is available now for Google Cloud customers, and other features of the suite are expected to be available later this year.
Blue Shield, Calif. has piloted the technology. The company is in the final stages of testing, Lisa DavisBlue Shield of California senior vice president and chief information officer told Helio.
“Our goal is to reduce manual ingestion and data entry into Blue Shield with artificial intelligence and machine learning technology from Google. So we spend a lot of time reviewing clinical documentation from providers. are often faxed and converted to PDF, but prior authorization decisions Davis said.
He added that the technology will help the company “capture, standardize and normalize information shared by provider partners (whether faxed or electronic) in a way that works best for them.”
“Exchanging data in this way reduces administrative processes and allows providers to spend more time with their patients,” she said. “Our aim is to increase and accelerate access to care for our members by streamlining the process so providers spend little time on pre-approval and make approved decisions in near real-time. be made available.”
According to Google, the suite will help medical plans meet current and proposed requirements for pre-approval by CMS. This includes an implementation of the Health Level 7 Rapid Medical Interoperability Resource Standard Application Programming Interface.
Google Cloud has also partnered with software companies Myndshft and Pegasystems on the program’s pre-approval application process, enabling them to check for missing information and monitor status while calculating out-of-pocket costs.
Talk to Helio Dr. Deepti Pandita, FACP, FAMIA, The chief medical information officer at the University of California, Irvine Health System, said the technology “will help reduce the time and resources the healthcare system spends on obtaining pre-approval. There are often security issues,” he said.
However, Pandita also said, “The algorithms behind the AI-enabled suite are private and are owned exclusively by Google.”
“It is unclear what data was used in the design. This always raises concerns about whether the platform is fair and whether there are ethical concerns,” she said.
