Case Studies

The University of Miami Health System delivers leading-edge patient care by the region's best doctors, powered by the groundbreaking research and medical education of the University of Miami Leonard M. Miller School of Medicine. As South Florida's only university system, UHealth is a vital component of the community. UHealth combines patient care, research, and education to create a frontline approach to health care.

UHealth seeks to provide excellence in patient/family centered care, reducing the human burden from illness by delivering high quality, compassionate health care, leading life-changing discoveries and transforming patient care through innovative research, education and prevention.

To streamline authorization processes, UHealth implemented Humata's PAthway platform, which integrates with state, regional, and national payers. PAthway supports the entire prior authorization continuum using automation and AI, triggering at the point of order. It helps providers determine what requires prior authorization, sources medical necessity policies for the plan, and uses its AI engine to curate recommendations for the clinical bundle. PAthway facilitates a seamless submission process, provides automated status updates until a final decision is reached, and constantly monitors changes to referrals that could lead to downstream denials or write-offs. Humata’s automation brought back ~68% of Orthopedic authorizations needing an authorization which allowed the team to eliminate 32% of unnecessary work.