Florida Blue announces rollout of AI authorization tool

by | Feb 21, 2022


 

Florida Blue, a leading health insurer in Florida, and artificial intelligence (AI) developer Olive today announced a collaboration to become the first U.S. payer to automate insurer authorization approvals through AI-powered clinical reviews, resulting in faster care for patients and greater provider satisfaction. According to Guidewell, the parent company of Florida Blue, the partnership will transform a frustrating, labor-intensive process, resulting in faster care for patients and improved provider satisfaction.

By deploying Olive’s AI platform, prior authorization decision-making translates to the point of care, like a doctor’s office or clinic. The solution will enable members to receive authorizations, the approval from the health plan before you get a service or fill a prescription, faster by giving providers immediate approval from GuideWell (sometimes before a member leaves their provider’s office) when Olive’s artificial intelligence determines the prior authorization request meets GuideWell’s medical necessity requirements.

“Olive’s AI platform helps GuideWell create a best-in-class utilization management model that reduces the administrative burden on our providers while creating a better experience for our members,” said Dr. Elana SchraderFlorida Blue Senior Vice President. “By being the first health plan to automate approvals, we are leading the way for insurers to close the technology gap to better serve our members and providers.”

GuideWell launched a pilot with Olive in Florida last year and saw impressive results: a massive reduction in time to decision by 10 days when immediate responses were available and a 27 percent decrease in unnecessary prior authorization requests, lessening the provider’s burden and operational costs and 48 percent faster decisions leading to faster patient care.

Telehealth has taken steps in the ongoing Legislative Session, unanimously passing a bill that would authorize physicians to prescribe certain drugs and medications through telehealth communication appointments.

“Since the onset of the pandemic, telehealth has been a blessing for many of my patients. It allows me to help my patients in nearly the same way I can when I see them in person; evaluating their symptoms, providing the care they need,” said Mayo Clinic Senior Resident Dr. Kamal Shair. “Allowing physicians like myself to be able to prescribe medications via telecommunication would help ease the accessibility for life-saving medications. In short, I urge you to pass this proposed bill.”

The AI rollout will take place in April, with plans for a full-scale implementation in July for more than 2.5 million commercial members.

“Olive is proud to partner with GuideWell to apply automation and AI to automatically prepare, submit and deliver payer-approved prior authorizations — one of the most broken processes in health care today,” said Jeremy Friese President of Olive. “Together, we are reimagining the care experience for patients, payers, and providers.”

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