Solution Summary
Hindsait AI Platform
Free up high-cost clinical staff, reduce turnaround times, raise provider/patient satisfaction scores, and improve accuracy all while reducing costs with Naviant’s Hindsait AI Platform.
About the Client
WPS®, a health solutions company, is committed to delivering superior quality and service to its government customers for their document processing needs.
Location
Madison, WI
Partnership reduces processing time by 30.27%
The Challenge
The federal government requested its partners to enhance the efficiency of medical documentation review by utilizing more computer technology to reduce processing time. WPS®, a health solutions company, set out to solve the problem.
The Solution
A collaboration between WPS and Hindsait yielded remarkable results. Eighteen use cases were successfully integrated into production, showing a significant 30.27% reduction in processing times for prior authorizations. With the adoption and successful integration of Hindsait’s solution into our document repository, WPS enhanced operational efficiency to ensure consistency and accuracy across the board, as evidenced by the rigorous processing of nearly 170,000 documents annually. This process helps with use cases within Appeals, Claims, and Medical Review.
The Summary
Artificial intelligence (AI) has emerged as a pivotal force reshaping various industries, and health care stands at the forefront of this transformation. While AI’s roots trace back through tech history, its recent surge into mainstream ushers in a new era of innovation, particularly in medical fields.
AI models are increasingly prevalent in today’s landscape. However, what distinguishes organizational leaders from laggards is their ability to leverage proprietary data and identify meaningful use cases that effectively merge AI’s capabilities with impactful business results.
Several years ago, the federal government issued a challenge: enhance the efficiency of medical documentation review through increased computer technology utilization. A crucial aspect of nearly every health insurance company’s operation is the meticulous review of unstructured health records, ensuring that submitted charges and requests align with robust medical evidence. While AI seems tailor-made for this task, implementing it within highly secure environments without widening the digital divide or compromising health equity presents a significant and complex challenge.
In late 2022, WPS’ Government Services division embarked on a transformative journey by partnering with Hindsait and using its machine-learning tools to identify connections and patterns that humans often miss.
The goal was to streamline business processes by leveraging AI and machine learning technologies. The resulting tool revolutionizes the medical review process by extracting key information from unstructured medical documentation, providing clinicians with concise summaries tailored to their specific use cases or request types. Notably, the deliberate focus on unstructured medical documentation over Electronic Health Record (EHR) integration acknowledges the prevalent use of fax or paper submissions by many health care providers. This integration ensures accessibility to the same advanced capabilities for rural health providers as larger hospital systems relying on robust Electronic Medical Records (EMR).
Since its inception, the collaboration between WPS and Hindsait has yielded remarkable results. Eighteen use cases have been successfully integrated into production, delivering a significant 30.27% reduction in processing time for prior authorizations. With the adoption and successful integration of Hindsait’s solution, WPS enhanced operational efficiency to ensure consistency and accuracy across the board, as evidenced by rigorous checks conducted on nearly 170,000 documents annually.
In a market inundated with AI models and tools, Hindsait’s unique offering shines. Its capacity to operate seamlessly within high-security infrastructures sets it apart, while its adaptability to swiftly configure and learn new use cases further solidifies its position as a frontrunner in the industry. Compared to the industry’s standard several months, WPS’ ability to expedite the transition from request to production within a mere two to three weeks per use case underscores the tangible efficiency gains and competitive edge derived from embracing AI-driven solutions.
Looking ahead, WPS is committed to documenting its ongoing AI journey and is dedicated to delivering superior quality and service to its government customers.
