Collaboration addresses major bottlenecks in prior authorization and medical review
Cambridge, England and ROCKVILLE, Md. — June 26th, 2018 — Linguamatics, the leading natural language processing (NLP) text analytics provider, and Secure Exchange Solutions (SES), a market leader in enabling the secure exchange of health information, today announced the selection of Linguamatics Health as the NLP platform for SES SPOT, a solution that, when combined with SES Fetch, streamlines clinical information exchange and automates the review process.
Inefficient medical review processes (either before or after submitting claims) are major contributors to rising costs in healthcare systems. SES SPOT was developed to evaluate clinical information to help control costs and improve outcomes so that patients receive the appropriate care rapidly, reducing manual effort for providers and public or private health plans, and providing the opportunity to dramatically save time and money.
SES SPOT includes Linguamatics I2E to provide Artificial Intelligence (AI) to extract information from both free text and codified data in an electronic medical record, to compare extracted data with guidelines, and to return evidence, recommendations and an audit trail to automate or semi-automate approval of claims.
“After an exhaustive review of 17 vendors, SES selected Linguamatics as the NLP engine most effective at identifying and extracting key clinical criteria, and for providing a reasoning layer to make a recommendation,” said Tom McGraw, SES senior vice president of product and government business.
“Combining Linguamatics NLP technology with other SES components will deliver the solutions needed to help relieve the pressure on both public and private healthcare systems caused by shifts in population demographics,” explained SES CEO Dan Kazzaz.
“The complexity of prior authorization and medical review means that there are major inefficiencies in these processes that impact cost, patient care and outcomes,” said Simon Beaulah, senior director, healthcare at Linguamatics. “SES and Linguamatics are tackling this challenge with AI approaches that streamline identification of clinical factors and provide recommendations and evidence to speed medical review. Significant savings can be achieved by automatically extracting, analyzing and summarizing all the evidence in the medical record related to the claim.”
Linguamatics transforms unstructured big data into big insights to advance human health and wellbeing. A world leader in deploying innovative natural language processing (NLP)-based text mining for high-value knowledge discovery and decision support, Linguamatics’ solutions are used by top commercial, academic and government organizations, including 18 of the top 20 global pharmaceutical companies, the US Food and Drug Administration (FDA) and leading US healthcare organizations.
Linguamatics I2E is used to mine a wide variety of text resources, such as scientific literature, patents, Electronic Health Records (EHRs), clinical trials data, news feeds, social media and proprietary content. I2E can be deployed as an in-house enterprise system, or as Software-as-a-Service (SaaS) on the cloud.
About Secure Exchange Solutions
Secure Exchange Solutions sets the standard for seamless, scalable, secure connectivity across organizational boundaries. As an industry-leading health information service provider, Secure Exchange Solutions protects, streamlines and delivers sensitive and critical health care information while ensuring compliance and improving efficiency and quality. Hospitals, health systems, physicians, health plans and channel partners rely on Secure Exchange Solutions for integrated secure communications that expand their reach and empower them to improve patient care and address value-based care.
Linguamatics Media contact:
Michelle Ronan Noteboom, Sr. Account Director
+ 1 512.426.2870
Secure Exchange Solutions Media contact:
+ 1 509.430.3515