Alaffia Health Announces Ask Autodor, its Generative AI Assistant for Healthcare Payers

Alaffia Health, healthtech company that provides AI-powered claim review solutions to healthcare payers and cost containment firms, today announced the launch of Ask Autodor, its AI assistant built to revolutionize the way health insurance companies review and process facility healthcare claims.

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After receiving early access to GPT-4, OpenAI’s state-of-the-art large language model, Alaffia Health meticulously built the most powerful AI tool for its clients and users. The company fine-tuned the foundational model by leveraging its own proprietary AI models, medical billing compliance algorithms, and clinical guideline databases. Ask Autodor expertly executes time-consuming tasks for knowledge workers in claims management, supporting core functions ranging from payment integrity to special investigations and utilization management.

Today, Ask Autodor optimizes the work of clinicians and claim analysts, automating complex tasks such as summarizing large unstructured medical records, sourcing clinical guidelines, and determining medical necessity for services. Ask Autodor helps its users review claims 20x faster, allowing healthcare payers to promptly reimburse providers and make utilization determinations. The AI assistant was also built to adhere to enterprise data security standards for managing Protected Health Information and other sensitive healthcare data, a key attribute not found in most publicly available large language models.

In its current state, Ask Autodor offers numerous advantages for healthcare payers and cost containment firms:

• Enhanced Operational Efficiency: Ask Autodor helps users review claims most efficiently, allowing claims departments to complete 20x more reviews within a given time period.
• Generate More Claims Savings: Ask Autodor helps users enhance both the scale and detail of their reviews, most accurately preventing unnecessary healthcare spending.
• Improved Compliance: With its intelligent decision support, Ask Autodor ensures that healthcare payers adhere to both plan-specific and industry-wide policies and best practices.
• Seamless Integration: Ask Autodor integrates directly with existing claim management and payment systems, allowing seamless user adoption.

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Alaffia Health believes that widespread adoption of AI is the key to solving one of the most critical issues adversely impacting our healthcare ecosystem—wasteful administrative spending—which, according to Health Affairs, amounted to $570B in 2019.

Commenting on the launch, TJ Ademiluyi, CEO of Alaffia Health, stated: “Most payers and cost containment firms have heard about the new AI models but aren’t aware of what they’re capable of or how to implement them to solve their bespoke challenges. That’s where we come in—we do all the heavy-lifting so they can quickly onboard and start deriving value from AI right away. Our goal is to ensure that every claim analyst and clinician leverages Ask Autodor to help them most effectively complete tasks and make critical decisions each day.”

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