Overview
Health plans often face delays and inefficiencies in clinical reviews due to manual processes, fragmented data and increasing documentation complexity. These challenges not only slow down decision-making but also increase the risk of errors, non-compliance and administrative overhead, ultimately impacting member satisfaction and operational performance.
HCLTech’s AI-powered clinical review solution addresses these issues by combining GenAI-led automation, semantic search and smart summarization to streamline the review process. It accelerates time to decision, enhances accuracy and ensures regulatory compliance. By empowering clinical teams with intelligent insights and automation, it enables them to focus on higher-value tasks and deliver faster, more consistent outcomes.
Key features of the solution:
AI-led document extraction and contextual summarization from diverse sources
Confidence scoring with actionable recommendations for faster validation
Embedded AI assistant for real-time guideline access and decision support
