+92%

Few experiences in healthcare are more frustrating than the prior authorization (“prior auth”) process. While the intent is logical—ensuring treatments and medications are medically appropriate and covered by insurance—the real-world experience is often anything but.

On paper, prior authorization makes sense. It’s designed to ensure that treatments are medically necessary and covered by a patient’s health plan. But in practice, it’s one of the most exasperating aspects of the U.S. healthcare experience—for both patients and providers.

Patients often describe it as a “slow way to be told no, in terms I don’t understand.” Meanwhile, providers face a growing administrative burden, dedicating countless hours and often entire teams to submitting prior auth requests and navigating complex coverage requirements.

The scale of the issue is staggering. The U.S. spends roughly $5 trillion on healthcare annually, and the prior authorization process touches a significant portion of that, impacting millions of lives and resulting in tens of billions of dollars in additional spending. This isn’t just a bureaucratic inconvenience. It’s a costly, time-consuming process with real consequences for care delivery and patient well-being.

Lazarus AI’s Applied Intelligence Engine Addresses the Delay.  Not the Coverage Decision.

There are two major sources of consumer frustration with prior authorization processing:

1. What’s covered and how much? – A difficult question that depends on policy details. That’s not where Lazarus AI focused during this initial engagement.
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2. Why does it take so long to get a response when I need treatment? – This is where we make a real difference.

Partnering with a Digital Solution Provider that supports prior authorization workflows, Lazarus AI helped reduce average response times for urgent requests from 72 hours to just six – a transformation from frustratingly average to exceptionally fast.

The Digital Solution Provider leveraged our document intelligence, extraction, and API-based AI capabilities to extract key patient and service details from typed and handwritten prior authorization forms, allowing them to feed this information into the insurer’s downstream applications. 

Lazarus AI’s Applied Intelligence Engine and underlying AI technologies were deployed to detect the urgency of each document, using built-in “urgency detection” logic that identifies keywords like “urgent” (including common misspellings), related terms, and checkbox indicators to flag time-sensitive requests. When urgency is detected, the Digital Solution Provider automatically routes those cases to a priority human-in-the-loop queue. 

These AI-driven process improvements reduced average turnaround time for urgent requests by 92%, enabling the Digital Solution Provider to deliver a more responsive and supportive experience for both patients and providers – where faster decisions directly impact care outcomes.

Want to improve the healthcare experience for your customers?

Let’s talk. Contact us at Lazarus AI to see how we’re reducing delays, enhancing care, and making prior auth a little less painful.