United StatesFinance and insurance2025 – ongoingGeisinger Health Plan
AI-assisted prior authorization with HealthHelp and Anterior
HealthHelp reported 50–70% shorter turnaround for Geisinger's escalated authorization cases
Problem
Geisinger Health Plan faced slow prior-authorization reviews and administrative work for providers. Escalated cases delayed decisions about patient care.
Approach
The health plan partnered with WNS-HealthHelp and Anterior. HealthHelp supplied utilization-management expertise, while Anterior provided AI-generated clinical recommendations. The partners reported results from the authorization workflow.
Results
Takeaway
The turnaround result applied to escalated cases requiring clinical review. The partners did not disclose the evaluation sample or baseline turnaround times.
Categories
- Size
- Large enterprise
- Industry
- Finance and insurance
- Business function
- Production and quality
- Innovation type
- Process innovation
- AI technology
- Generative AI
- Adoption
- Partner co-development
- Evidence
- Vendor case study
Sources
Source summaries
HealthHelp described the partnership with Geisinger Health Plan and Anterior. It reported 50–70% shorter turnaround for escalated clinical reviews and 76% fewer approvals requiring human review.
Full details are in the original sources.