A Case Study of Artificial Intelligence in Healthcare
A Case Study of Artificial Intelligence in Healthcare
Ai & Machine Learning
Florida Blue, the state’s Blue Cross and Blue Shield provider, in collaboration with Olive, a pioneer in healthcare automation, has announced a groundbreaking initiative aimed at transforming healthcare service delivery through technology. This partnership marks a significant milestone as Florida Blue becomes the first U.S. health insurer to implement AI-driven clinical reviews for rapid prior authorization approvals, enhancing both member care and provider satisfaction.
The innovative use of Olive’s AI platform is set to overhaul the traditionally cumbersome prior authorization process!
One which often involves lengthy phone calls and paperwork, and can delay medical procedures by up to 15 days. Currently, Florida Blue processes hundreds of thousands of such requests annually.
Dr. Elana Schrader, Senior Vice President of Healthcare Services at Florida Blue and President of GuideWell Health, emphasized the transformative potential of this collaboration. “By integrating Olive’s AI technology, we not only streamline our utilization management but also significantly enhance our member experience by reducing the administrative load on healthcare providers,” she explained.
With the deployment of this AI solution, prior authorization decisions can now be made directly at the point of care, such as during a doctor’s visit. This means that approvals can be granted almost instantly when the AI determines that the medical necessity criteria are met, potentially even before a patient leaves the doctor’s office.
The pilot program launched last year by Florida Blue and Olive demonstrated substantial improvements, including a reduction in decision-making time by an average of 10 days, a 27 percent drop in unnecessary authorization requests, and 48 percent quicker authorizations, thus accelerating patient care significantly.
Jeremy Friese, President of the Payer Market at Olive, shared his enthusiasm about the collaboration. “We are proud to partner with Florida Blue to automate one of the most challenging processes in healthcare today. This initiative not only redefines the care experience for all involved parties but also paves the way for more efficient healthcare delivery,” he said.
The full-scale implementation of this AI platform is set to begin in July and will benefit over 2.5 million commercial members of Florida Blue. This initiative is expected to set a precedent for the use of technology in health insurance, potentially inspiring similar advancements across the industry.
Florida Blue has been a leading health insurance provider in Florida for over 75 years, dedicated to improving the health of its community. Similarly, Olive continues to tackle significant challenges in healthcare through automation, enhancing system connectivity and operational efficiency for a brighter, healthier future. For more information on Olive and its initiatives, visit oliveai.com.
