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Care Advisor: NexAuth

AI-Powered Prior Authorization Solution

INTRODUCING NEXAUTH

Streamline Prior Authorization and Cut Costs with AI

Prior authorization is essential but can be a bottleneck in healthcare delivery, delaying treatment and increasing administrative burdens. Care Advisor: NexAuth is designed to change that. By applying advanced AI and machine learning to existing workflows, NexAuth accelerates decision-making, improves accuracy, and enhances patient and provider experiences.

 

Revolutionize Your Prior Authorization Process

With Care Advisor: NexAuth, healthcare payers can:

  • Reduce Decision Times by Up to 40%: AI automates routine processes, significantly cutting down on manual paperwork and enabling faster approvals.
  • Improve Accuracy and Compliance: AI-powered insights help your team make more precise decisions, reducing unnecessary denials and rework.
  • Lower Operational Costs: By streamlining workflows, NexAuth can reduce administrative expenses by up to 30%, allowing payers to reinvest savings into patient care and innovative services.

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ADDRESSING THE CHALLENGE

The Modern PA Process is Broken

Outdated PA systems, fragmented tech, and manual processes not only contribute to an estimated $950B in administrative costs but also cause 94% delays in patient treatment. As prior authorization demands grow, healthcare organizations struggle to balance immediate and long-term goals with delivering optimal patient care. Existing automation capabilities meet business needs, but do not deliver high impact value.

NexAuth State of Automation-4

Modular AI-Enabled Services

NexAuth offers four distinct AI-enabled services. Each service is crafted with flexibility at its core. Choose and integrate one or more services that align perfectly with your priorities.

01
Intake
Intake

AI-enabled document processing, standardization, storage and querying of prior auth submission data.

02
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Case Validation

Intelligent algorithms search patient-specific information for more than 2,000 payers, clearinghouse databases, and direct connections infrastructure to find more active coverage for healthcare billers.

03
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Clinical Recommendation

A service that ingests submission data, policy coverage, evidence-based data, medical history, and guidelines and uses Vertex AI  to provide a personalized approve/deny recommendation for a specific prior authorization.

04
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Clinician Review

A service that processes coverage details, policy information, and evidence-based data for specific prior auth requests, utilizing Vertex AI to aid clinicians in reviewing and quickly summarizing key information and responding to their queries.

Navigate prior authorization complexities with confidence

NexAuth equips payers with intelligent automation to close the gap in PA and enable seamless continuity of care with modular AI-enabled services built on the Google Cloud Platform.

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Plug-and-play efficiency

Seamlessly extend your existing systems or add further transformative functionality to a newly adopted end-to-end platform.

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Customized services

Select one or all of NexAuth's services, each designed to meet your specific requirements.

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Future-proof technology

Achieve agility and scalability to stay ahead of the evolving healthcare landscape.

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Seamless transition

Realize the full potential of innovation without the drawbacks of complex change management.

Strategic partners
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Leveraging Google Cloud's scalable infrastructure and advanced AI capabilities, we create robust, secure, and intelligent healthcare solutions that drive meaningful insights and improve outcomes. Learn More
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Overcome data integration challenges and concentrate on delivering quality patient care through efficient data access. Learn More
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Simplify healthcare administration by reducing time on billing and authorizations to allow providers to focus more on patient care.

Everything you need to know

FAQs

What is NexAuth?

NexAuth is a suite of AI-enabled services for quick integration with payer-managed prior authorization workflows. It streamlines processes, cuts costs, and improves member satisfaction, while offering the flexibility to deploy one or all of its AI-enabled services to enhance automation and efficiency.

Who can benefit from NexAuth?
NexAuth is ideal for healthcare payers of all sizes, looking to enhance their existing automation processes with advanced AI capabilities, whether they manage operations in-house or with the help of Business Process Outsourcers (BPOs).
How Does NexAuth utilize AI in the prior authorization process?
NexAuth employs AI-enabled capabilities to analyze and process authorization requests, enhancing decision-making accuracy and speed and reducing manual workload.
What are the key features of NexAuth?
NexAuth includes a set of modular AI-enabled services that can be plugged into existing prior authorization applications. These services include: Intake, Case Validation, Clinical Recommendation, and Clinician Review. These services are designed  to add greater value to existing prior authorization applications or newly adopted end-to-end platforms.
How does NexAuth integrate with existing automated systems?
NexAuth is designed for seamless integration with various healthcare systems and Electronic Health Records (EHRs), complementing and enhancing existing automated workflows with AI technology.
Does NexAuth support real-time decision-making?
Yes, NexAuth's AI-enabled capabilities enable real-time analysis and processing, facilitating quicker decision-making in the prior authorization process.
What is the typical deployment timeline for NexAuth?
The time to deploy NexAuth varies based on specific client requirements and existing infrastructure but is generally accomplished within a few months.
How does NexAuth ensure data security and compliance with healthcare regulations?
NexAuth incorporates stringent security measures to protect sensitive patient data and adheres to healthcare regulations, ensuring safe and compliant operations.

Let's Talk

Ready to experience AI-enabled prior authorization?

Break down traditional care barriers and re-imagine prior authorization automation fueled by efficiency and real-time decision-making.

Get Started

FEATURED GUIDE

The ultimate guide to prior authorization

Download this guide from our partner, Myndshft, to get answers to all of your top-of-mind questions around the prior authorization process.

Download Guide
Ultimate Guide to Prior Auth

Ready to discuss your project?

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