Arrive Health
Areas of Focus
AI Development
Arrive Health is a healthcare technology company that works to make care decisions better for patients and providers, improving affordability, access, and outcomes — all while reducing administrative burden.
01
The Challenge
Arrive Health was looking for a way to speed up the prior authorization process, a process that health insurance companies use to determine if a service, medication, or procedure is medically necessary. Historically, this process has been very inefficient and produced a high volume of denied authorizations, which still cost providers and Pharmacy Benefit Managers (PBM) significant time and money to review.
Arrive Health saw an opportunity to use AI to help healthcare providers understand medication coverage criteria before they begin filling out a prior authorization request, enabling them to cancel or gather more documentation rather than generate requests just to be denied. However, Arrive Health didn’t have the internal AI capability to build a scalable solution that could manage the volume and variety of policy information across hundreds of thousands of medications and insurers, all while integrating seamlessly with their current tech infrastructure.
02
The Solution
Arrive Health partnered with Artium to develop an LLM-powered engine to validate whether AI could accurately summarize policy information into concise, actionable insights. If it could, these summaries would help medical admin workers understand when a request would surely not meet the criteria for prior authorization before submitting it to the PBM, saving significant effort for both sides.
Leveraging Anthropic’s Claude on AWS Bedrock, the engine streamlined policy data, connected with FDA and internal databases, and allowed healthcare SMEs to refine AI outputs for accuracy.
Thoughtful prompt engineering also kept processing costs minimal, which met Arrive Health’s goal of developing a solution that would be affordable even at scale.
03
The Outcome
After 10 weeks of rapid iteration and experimentation, the AI-powered engine successfully demonstrated its ability to streamline the prior authorization process. Early results indicate a reduction in unnecessary prior authorization requests, helping providers make quicker, data-driven coverage decisions.
Arrive Health is currently piloting this program with the University of Pennsylvania Medical Clinic.