{"paper":{"title":"Can GPT Improve the State of Prior Authorization via Guideline Based Automated Question Answering?","license":"http://creativecommons.org/licenses/by-nc-sa/4.0/","headline":"","cross_cats":["cs.AI","cs.LG"],"primary_cat":"cs.CL","authors_text":"Ayush Singh, Shabnam Tafreshi, Shubham Vatsal","submitted_at":"2024-02-28T15:39:53Z","abstract_excerpt":"Health insurance companies have a defined process called prior authorization (PA) which is a health plan cost-control process that requires doctors and other healthcare professionals to get clearance in advance from a health plan before performing a particular procedure on a patient in order to be eligible for payment coverage. For health insurance companies, approving PA requests for patients in the medical domain is a time-consuming and challenging task. One of those key challenges is validating if a request matches up to certain criteria such as age, gender, etc. In this work, we evaluate w"},"claims":{"count":0,"items":[],"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"source":{"id":"2402.18419","kind":"arxiv","version":2},"verdict":{"id":null,"model_set":{},"created_at":null,"strongest_claim":"","one_line_summary":"","pipeline_version":null,"weakest_assumption":"","pith_extraction_headline":""},"integrity":{"clean":true,"summary":{"advisory":0,"critical":0,"by_detector":{},"informational":0},"endpoint":"/pith/2402.18419/integrity.json","findings":[],"available":true,"detectors_run":[],"snapshot_sha256":"c28c3603d3b5d939e8dc4c7e95fa8dfce3d595e45f758748cecf8e644a296938"},"references":{"count":0,"sample":[],"resolved_work":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57","internal_anchors":0},"formal_canon":{"evidence_count":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"author_claims":{"count":0,"strong_count":0,"snapshot_sha256":"258153158e38e3291e3d48162225fcdb2d5a3ed65a07baac614ab91432fd4f57"},"builder_version":"pith-number-builder-2026-05-17-v1"}