Sarcouncil Journal of Engineering and Computer Sciences

Sarcouncil Journal of Engineering and Computer Sciences

An Open access peer reviewed international Journal
Publication Frequency- Monthly
Publisher Name-SARC Publisher

ISSN Online- 2945-3585
Country of origin-PHILIPPINES
Impact Factor- 3.7
Language- English

Keywords

Editors

Smart Prior Authorization Using AI and NLP: Transforming Healthcare Administrative Efficiency Through Intelligent Automation

Keywords: Artificial Intelligence In Healthcare, Natural Language Processing, Clinical Decision Support Systems, Healthcare Automation, Prior Authorization Efficiency.

Abstract: Using artificial intelligence and natural language processing to change how prior authorizations work is a big step forward for handling healthcare. It fixes old problems that have made things hard for doctors and slowed down care for patients. This article looks at how machines are changing authorization processes, turning old manual tasks into simple, tech-driven ones. These language models can read medical documents and use cloud systems to keep up with rules. This setup lets decisions happen fast while keeping things accurate. These systems are good at pulling info from different medical documents, matching patient stories to standard codes, and checking if treatments match proven guidelines. This change isn't just about working faster. It also helps with medical choices. Machine learning checks if treatments are needed, spots when things are overused, and gives custom advice based on the patient. Hospitals that use these tools say they have less paperwork, better income management, and happier patients who get the treatments they need faster. Artificial intelligence is setting new standards for how well healthcare is run. It is also improving care and how resources are used.

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