Case Study: Fortune 100 Health Plan achieves a 55% reduction in prior authorization processing time with Autonomize AI

How a Fortune 100 Health Plan Cut Prior Authorization Processing Time by 55%

Fortune 100 Health Plan Company was facing a major prior authorization bottleneck: UM nurses were handling an overwhelming daily volume (80,000+ requests) with an average 35-minute review time per request, extracting data from faxes, PDFs, EMRs and handwritten notes. To address scalability, compliance, and clinician burden, the organization turned to Autonomize AI’s Prior Authorization Copilot.

Autonomize AI deployed the Prior Authorization Copilot to automate intake, extract and summarize unstructured data, adjudicate requests against clinical criteria, and generate audit-ready documentation while keeping clinicians in control. The results included a 55% reduction in processing time (35 mins to <15 mins), a 49% faster decision turnaround (3.65 to 1.80 days), 76% automation of intake, 18 minutes saved per prior auth (millions in FTE savings), 36,000+ clinical hours recouped monthly, and a 16% improvement in compliance.