Utilization Management Automation demo
Every open request on one live board with its clock; agents chase what is missing while there is still time to decide. 1:16
What the demo shows
A UM workflow solution for health plans that ranks open requests by time left on their clock.
Six agents read every request on every page the moment it arrives, start its clock at receipt, chase the records it lacks, predict its outcome and the reviewer it needs, and rank the whole queue by time left; nurses approve, physicians make every denial, and the yearly public metrics come from the same record.
Transcript
- Utilization Management Automation ranks every open prior authorization request by time left on its clock.
- Plans must decide in 72 hours or 7 days, yet requests still come by fax.
- 214 requests, each a bar burning down, expedited in red.
- An agent rereads Friday's faxes and finds an expedited box ticked on page 2.
- Walter Kaminsky's request jumps to the top with four hours left.
- It predicts approval by a nurse, saving medical director time for the hard cases.
- The missing therapy evaluation arrived 37 minutes after the agent asked.
- Teresa takes the top request and approves, with two and a half hours to spare.
- Every decision feeds the public metrics.
- No missed deadline since GoLive.
- Built on Botminds: agents, data, screens, and governance on one platform.
Transcribed from the film’s narration. Captions are on the player.