Document-Level AI Validation for Prior Authorization Using Iceberg + Vision Models

Abstract

This work presents a novel approach employing a combination of Iceberg, a scalable data processing platform & also advanced Vision models to maximize the prior authorization process in healthcare by means of their document-level AI validation. Often arduous, slow, and prone to errors, the current prior permission system causes administrative burden, delays patient care & also increases their running expenditures. Our solution uses AI-driven validation mechanisms that, upon system upload including medical data, referrals, or insurance forms activate in actual time. Utilizing Vision models meant to find, extract & verify key clinical & insurance data components, papers are quickly processed & evaluated utilizing Iceberg's strong data management capabilities. This computerized validation layer ensures that given documents match the payer's requirements before human examination, therefore reducing iterative communication & rework. Our approach gives accuracy, scalability & respect of healthcare standards first priority. Actual time artificial intelligence feedback used throughout the upload process increases submission correctness & also completeness and lets care teams apply quick corrective actions. Early results of pilot implementations show a significant drop in processing times, a decrease in rejections resulting from absence or incorrect data, and improved staff output. By incorporating intelligence at the document intake level, this system has the ability to revolutionize healthcare administrative processes, improve patient outcomes via accelerated approvals and lower care delivery costs