Innovaccer has developed an AI-driven utilization management platform called Galaxy UM. This platform is meant to improve the process of prior authorization for health plans. It reduces administrative burden and improves health outcomes. It addresses existing issues in the process, such as inefficient processes, the use of faxes for requests, and inefficient decision-making. The platform provides an automated experience for the entire utilization management process. This includes data intake, data extraction, and communication with providers in real time. It processes unstructured data from clinicians through agentic AI, natural language processing, and optical character recognition. The key feature of the platform is the “only auto-approve, never auto-deny” approach.
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This approach ensures that complex cases are handled by clinicians. It also provides transparency and prevents inappropriate denials. The platform operates on Innovaccer’s Health Cloud. This provides access to data for better decisions and efficient operations. It also supports compliance with evolving regulations, including CMS-0057, through automated tracking and reporting. “Utilization management should enable better care, not delay it,” said Abhinav Shashank, cofounder and CEO of Innovaccer. “With Galaxy UM, we are bringing together AI and clinical intelligence to streamline prior authorization, reduce administrative burden, and ensure that decisions are faster, more transparent, and aligned with patient needs. This is another step in our vision towards autonomous healthcare.”
