Utilization Management AI

CV and NLP Data Annotation for Medical AI

Automate tasks, analyze data, and generate insights to optimize resource utilization and improve healthcare delivery.

With the increasing role of AI in enhancing utilization management for optional usage of healthcare resources, such as medical services, procedures, and facilities, the training data needs of these AI applications continue to surge. With 10+ years of experience in data annotation for Medical AI and an enterprise-grade end-to-end data labeling platform, we power utilization management applications with high-quality training data.

POC and Automated Prior Authorizations

Automate review of medical records to streamline the point-of-care and prior authorization process for medical care against coverage.

Organize information from electronic health records, medical protocols, and other sources to reduce time-consuming tasks. This can help reduce administrative burdens and accelerate the approval process.

AI-assisted Clinical Decisions

Analyze and annotate patient data, medical literature, and guidelines to fuel AI-powered clinical decision support systems. AI-powered clinical decision support systems can assist healthcare providers in making informed decisions about patient care.

These systems can recommend appropriate treatments and interventions, ensuring that resources are allocated effectively.

Fraud Detection

Detect anomalies and patterns indicative of fraudulent activities, such as unnecessary medical procedures or overbilling in medical invoices.

Identifying and preventing fraud with our consensus workflow helps save costs and ensure the legitimacy of healthcare needs.

NLP for Document Analysis

Extract relevant information from unstructured medical documents, such as clinical notes, reports, and patient records.

iMerit medical annotation team can assist in automating the analysis of medical information for utilization management purposes.

Case Study

utilization management

iMerit Improves NLP Model to Reduce Manual Audits and Accelerate Claims Processing for a Top Healthcare Insurance Company

iMerit worked with a leading healthcare insurance provider to enhance its NLP (Natural Language Processing) model that was falsely rejecting claims, resulting in costly manual audits.

The iMerit team of medical annotators extracted and labeled thousands of healthcare documents and the data was used to retrain the model, resulting in a 68% reduction in manual audits.

24

%

Accelerated Claims Processing

68

%

Reduction in Manual Audits

99

%

Annotation Quality

"Our work with iMerit helped us reduce the need for manual auditing by 68%."

– Director of Data Science & AI, Top 3 Healthcare Insurance Company

Why Work With Us

Our expert-in-the-loop data processes and automation tools have enabled us to generate high-volume training data for claims processing, pre-authorization approval, and benefits verification applications. Using US board-certified physicians, iMerit facilitates regulatory approval through validation and benchmarking.

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