Highmark Health, Abridge Partner to evolve AI for payers / suppliers

Highmark Health has teamed up with Healthcare Abridge’s AI company to deploy its ambient clinical documentation platform and co-develop a previous authorization solution, companies announced on Tuesday.

Highmark Health, based in Pittsburgh, Pennsylvania, is the parent company of Highmark, health insurer with more than 7 million members, and Allegheny Health Network, a health system with 14 hospitals. Abridge, also based in Pittsburgh, offers an AI platform that aims to improve patient results and reduce administrative charges for suppliers.

Thanks to the partnership, the Abridge Ambient Clinical Intelligence Platform will be integrated into the locations of offices and the Algheny Health Network hospitals. The platform takes patient-clinical conversations and transforms them into clinical notes. After obtaining the patient’s consent, conversations are recorded using a phone or computer. The clinical notes are created in real time in the clinician’s work flow, and the clinician is able to review and modify the notes before adding them to the patient’s DSE.

The use of this technology reduces the time that clinicians must spend notes and allows them to spend more time with patients, depending on the businesses. The implementation of Abridge’s ambient technology will start in ambulatory locations, but will ultimately be deployed on the entire health system.

Highmark Health and Abridge also work together on the construction of a new previous authorization technology. During visits to patients, the technology will identify when the prior authorization is necessary and will ask the clinician to complete the missing information for authorization before the patient leaves the room.

“The platform will automatically generate the request with all the information required for real-time approval,” Abridge spokesperson told Medcity News. “Abridge’s related evidence architecture allows the clinician to verify everything in the note generated by AI and request the transcription and audio of the source of the conversation, so that they can be sure that the information is correct and complete.”

This is based on the gold carding program of Highmark Health, which grants gold cards to practices and doctors with a proven history of high prior authorization approval rate. Once carded in gold, doctors only have to subject a prenotification to plan the services, and approval is granted immediately. Highmark Health also offers an active gold cardons program, through which Highmark works directly with clinicians, offering coaching to help them submit specific and clinically appropriate requests.

“While those [gold carding] Initiatives can increase previous authorizations that occur at the care point after meeting, Abridge technology invites clinicians to necessary information during visits to patients, leading to faster and less refusal approvals, which ultimately helps patients maintain the continuity of health care, in an email.

In the end, this partnership between Highmark Health and Abridge aims to improve health results and make care more affordable, added Clarke.

“Patients will have more facial time with their doctors thanks to the technology of the ambient scribe that we adopt [Allegheny Health Network]”, He said.” Monitoring care will be approved more effectively through the previous automobile solution. As collaboration ripens, we will seek other ways to creatively deploy AI tools and solutions in our existing workflows and throughout the continuum of care. »»

Photo: Abridge and Highmark Health