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Transforming Prior Authorization Submission and Coverage Determination with GenAI
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Reports Transform PA and BV with GenAI

Transforming Prior Authorization Submission and Coverage Determination with GenAI

Executive Summary
Benefit Verification (BV) and Prior Authorization (PA) are integral to ensuring patients receive timely access to treatments. Yet, the reality is often complex—manual processes, inconsistent requirements, and delayed coverage determination can hinder patient enrolment and care delivery. The GenAI-powered solution transforms these challenges into opportunities. By automating key workflows and utilizing real-time data, it brings efficiency and speed to coverage determination and prior authorization processes.
Discover more about how you can reduce administrative burdens and set new standard in healthcare operations in our infographic.
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Conclusion

Prior authorization and coverage determination are essential parts of any patient support program. With the integration of GenAI, these processes are no longer barriers but opportunities to achieve operational and cost efficiencies that were previously unattainable. As GenAI continues to evolve, patient support programs will also advance—becoming more personalized, cost-effective, and efficient.

Authors

Vikrant Ghai
Vikrant Ghai
Arindam De
Arindam De

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