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APPLYING AI TO PRIOR AUTHORIZATION REDUCES THE PAIN FOR ALL STAKEHOLDERS

 * 

Alina Czekai, Cohere’s VP of Strategic Partnerships, sits down with Karen Jagoda
of the Empowered Patient Podcast for a wide-ranging discussion on how we’re
transforming the prior authorization process.

During the podcast, Alina discusses why the prior authorization process is a
multidimensional challenge that requires understanding the entirety of care and
leveraging technology and AI to help guide behavior toward what is most
clinically appropriate.

Alina explains, “You can think of it as an authorization for a credit card.
Ensuring that what is going to be done or what medication or devices are going
to be ordered is actually going to be paid for. The process and payments in the
healthcare system today have become so complex. It’s complex not only for the
health plan that’s administering payments for care but also for physicians and
their staff. Most importantly, it’s a confusing and stressful process for
patients.”

“We believe that prior authorization is a process that can be automated, that
should be automated and is really an opportunity in the patient journey to
ensure all stakeholders are on the same page. We also think that tools like
prior authorization can really be leveraged to understand what’s next in a
patient’s care journey.”

“Prior authorization, for years, has relied on fax. We’re not trying to put the
fax machine totally out of business, but we think that we can really automate
this important process and make access to care even faster for patients.”

Listen Here
Published On: June 22nd, 2023Categories: News, Podcast

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ABOUT THE AUTHOR: ALINA CZEKAI

Alina M. Czekai, M.P.H., is Vice President of Value-Based Care Strategy at
Cohere Health. Previously, Alina served as a Senior Advisor to CMS Administrator
Seema Verma, leading the agency’s relationships with the healthcare industry and
maximizing public support for CMS’s priorities and overarching mission. In her
current role, she is responsible for devising and executing the company’s
strategy for value-based care, including new product development and
partnerships.
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Boston, MA 02114
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