Healthcare · Coastal Health Network
Prior authorization, without the 14-day stall.
Median turnaround cut from 11 days to 36 hours. Appeal win-rate up 18 points.
Challenge
A regional health system was losing revenue and clinician time to prior-authorization backlog. Leadership wanted 'an AI copilot.' The real constraint was fragmented EHR extracts, no governance for PHI in third-party tools, and a staff who had already survived two failed digital programs.
Approach
Governance first: data-handling rules, BAA posture, and an explicit list of what would never leave the firewall.
We mapped the authorization path with nurses and billing — not with the vendor's happy-path diagram.
Pilot scoped to three high-volume CPT families. Success was time-to-decision, not 'AI adoption.'
Change plan included a 90-minute floor workshop and a named clinical owner on every shift.
Outcome
What moved.
The pilot cleared the three families in six weeks, then expanded. No PHI incidents. The board received a one-page ROI brief they could actually read. Coastal now runs a quarterly AIDA re-score instead of buying the next tool that knocks.
Client names are used with permission or as published composites. Every figure on this page traces to a specific engagement and can be walked through on a call. Confidential work stays unpublished.
Next step
A similar constraint?
If the problem looks familiar, the discovery call is the right next hour.