Uploaded June 2026 | Updated September 2026, 2 weeks ago
Healthcare providers lose over 13 hours weekly navigating prior authorization workflows, with 30% of requests denied and 24% of first-submission claim denials attributed to authorization failures—a $262 billion annual industry burden. Non-clinical administrative staff lack the clinical training to interpret complex payer medical necessity policies, resulting in incomplete submissions and costly resubmission cycles that delay patient care. This session demonstrates an Amazon Bedrock-powered intelligent assistant that empowers non-clinical staff to validate prior authorization requests against payer-specific medical necessity criteria before submission, driving right-first-time approvals. The solution intelligently extracts CPT codes, diagnoses, and payer details from authorization requests, performs automated policy matching through a Bedrock Knowledge Base containing payer-specific criteria, and delivers gap analysis with actionable recommendations for missing documentation.
github.com/aws-samples/sample-prior-authorization-assistant
Healthcare providers lose over 13 hours weekly navigating prior authorization workflows, with 30% of requests denied and 24% of first-submission claim denials attributed to authorization failures—a $262 billion annual industry burden. Non-clinical administrative staff lack the clinical training to interpret complex payer medical necessity policies, resulting in incomplete submissions and costly resubmission cycles that delay patient care. This session demonstrates an Amazon Bedrock-powered intelligent assistant that empowers non-clinical staff to validate prior authorization requests against payer-specific medical necessity criteria before submission, driving right-first-time approvals. The solution intelligently extracts CPT codes, diagnoses, and payer details from authorization requests, performs automated policy matching through a Bedrock Knowledge Base containing payer-specific criteria, and delivers gap analysis with actionable recommendations for missing documentation.
github.com/aws-samples/sample-prior-authorization-assistant
