Client Result
From delays to 90% Faster Outcomes With AI
Reducing operational strain by introducing AI into claims and prior authorization workflows
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Client Result
Reducing operational strain by introducing AI into claims and prior authorization workflows
During a critical platform migration, the client faced mounting challenges with manual prior authorization and claim matching. West Monroe stepped in as a trusted partner, assessing their end-to-end process and identifying inefficiencies. Together, we developed a strategy to address the root causes while aligning with their goals. By introducing AI-based automation solutions and improving workflow visibility, we empowered the client to manage authorizations more effectively, reduce delays, and lay the groundwork for long-term success with smart, scalable systems that grow alongside their needs.
Our experts collaborated closely with the client, combining healthcare and technology expertise to address the growing backlog. Together, we prioritized claims, decentralized decision-making, and introduced AI-enabled automation for repetitive tasks. By aligning these solutions with their goals, we streamlined the management-to-claims process. This AI-infused approach didn’t just solve today’s issues—it built lasting resilience for tomorrow’s demands.
Through collaborative problem-solving and generative AI-powered automation, the client achieved transformative results. In three months, their pended claims backlog dropped by 90%, while weekly monitoring reduced authorization errors by 60%. These improvements saved $500,000 by eliminating manual rework and penalties. Now equipped with a scalable AI solution, the client is prepared to deliver faster, more accurate payments—and confidently meet the future demands of healthcare operations.
A leading Midwest health plan turned to West Monroe to explore how AI could relieve pressure from outdated, manual processes. Manual claims authorizations were causing delays, resource strain, and costly backlogs during a platform migration. Together, we introduced AI-driven automation that streamlined claims intake and prior authorizations. In just three months, we cleared 90% of the claims backlog, reduced errors by 60%, and saved $500,000 annually. AI now enables faster, more accurate routing, allowing teams to focus on exceptions—not every claim. Today, the organization operates with a scalable, intelligent system ready for future growth.
annual cost reduction through process automation
reduction in claims backlog over three months, driving faster results
fewer authorization load errors per week, creating new efficiencies