Use Cases for Healthcare Payers: Utilization Management Determine member eligibility and initiate pre-authorization review and approval for procedures and tests. CUSTOMER PROFILE: • Large healthcare payer operating in multiple states • Over $10 billion in revenue, 10 million members and 15,000 employees CHALLENGE Manual processes and complex, changing guidelines causing inaccurate pre-authorization approvals: • Current process prone to human error. Achieving a 98%-98.5% success rate, yet the remaining 1.5%-2% represents tens of millions of dollars paid out in error due to false approvals; including those for high value procedures and tests for Maternity, NICU Admission, and Surgery • Care Coordinators in the contact center take call notes in a notepad and use spreadsheets to

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