Going Beyond Medical Policy Digitalization to Enable Automation At Sale скачать в хорошем качестве

Going Beyond Medical Policy Digitalization to Enable Automation At Sale

In Part 3 of our series, Lisa Bowden and Lydia Turner take a deeper look at the foundation of every utilization management (UM) decision: medical policy. Lydia explains why medical policy codification is the “engine” behind both automation and clinical accuracy and why outdated, ambiguous, or unstructured policies can undermine even the most advanced UM strategies. Lydia breaks down what health plans must do to ensure their policies are accurate, current, machine-readable, and evidence based, so they can be safely used by automation and AI. She also discusses the governance structures health plans need to create long-term consistency, shared accountability, and sustainable ROI. Learn More This episode expands topics from our “Reclaiming Utilization Management” webinar on moving from fully delegated UM to hybrid/insourced models. To learn more about Availity’s Intelligent Utilization Management Solution, visit https://www.availity.com/intelligentu...