Abridge, Highmark Health testing use of AI for prior authorizations| STAT

Abridge is partnering with payer-provider Highmark Health to develop an artificial intelligence tool that would facilitate in-visit insurance approvals, the companies announced on Tuesday.

Abridge, which sells ambient AI scribes that listen to patient visits and write doctors’ notes, has heavily marketed its new coding and billing tools this year in its $250 million and $300 million series D and E fundraises. But as commoditization of the technology and new ambient note tools from incumbents like Epic threaten the AI scribe market, Abridge is aiming to convince providers that its platform is worth paying for. Hiccups with insurance approvals slow down patient care and prevent health systems from getting paid — making it a promising area to grow the slim financial returns for AI scribes. 

This move marks the first time Abridge has integrated with an organization other than a health care provider. Instead of filling out paperwork for insurance approvals after the visit, the AI will know all of Highmark’s prior authorization requirements and will notify doctors within the visit if their conversation has touched on all the information the insurer wants in order to approve the procedure. It will also fill out and submit forms and track the status of requests.