Case Study: Leading Healthcare & Insurance Company achieves streamlined, guideline-compliant prior authorization workflows with Shaip

Enhancing Prior Authorization Workflows through Guideline Adherence Annotations

Leading Healthcare & Insurance Company engaged Shaip to address persistent bottlenecks in its prior authorization process, where demonstrating adherence to evolving InterQual clinical guidelines across complex medical records was time-consuming and error-prone. Shaip delivered Clinical Data Annotation services, leveraging LabelBox for PDF medical record annotations and mapping case evidence to InterQual questionnaires to ensure guideline-aligned decisions.

Shaip annotated over 6,000 prior authorization cases in a six‑month engagement, applying dual‑blind annotation with arbitration, rigorous QA, HIPAA‑compliant data handling, and ongoing training—while providing biweekly project updates. The result was a streamlined prior authorization workflow with improved adherence accuracy to InterQual guidelines, on‑time delivery of labeled records, and measurable operational efficiency gains that supported better patient care and faster payer-provider decisions.