Customer Success Story

How ProAct increased reviewer productivity by up to 40% with AI-assisted clinical data extraction

During an initial pilot of ClinIntel within PAHub, ProAct reviewers completed prior authorization reviews up to 40% faster while maintaining strong AI accuracy and expanding use across additional product lines.

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689 Completed reviews
5,946 AI questions answered
88% AI completion
83% ClinIntel answers accepted by reviewers
17% Human intervention*
The Story

Less manual review. More focus on clinical decisions.

The Opportunity

ProAct needed a more efficient way to review lengthy clinical documentation, locate supporting evidence, and answer repetitive questions as authorization volumes increased.

01
Customer

The Customer

ProAct is a growing pharmacy benefit manager focused on delivering clinically driven pharmacy benefit management while maintaining exceptional service and operational efficiency.

Growing pharmacy benefit manager
Clinically driven operations
Focused on service and efficiency
02
Challenge

The Challenge

Reviewers were spending valuable time manually reviewing clinical documentation, locating supporting evidence, and answering repetitive questions before making informed authorization decisions.

  • Reviewing lengthy clinical documentation
  • Searching for supporting clinical evidence
  • Manually answering repetitive questions
  • Spending time on administrative work
03
Solution

Our Solution

ProAct implemented ClinIntel within PAHub to analyze submitted clinical documentation, identify relevant clinical evidence, and pre-populate answers to clinical questions.

  • AI-assisted review of submitted documentation
  • Relevant clinical evidence surfaced automatically
  • Answers pre-populated for clinical questions
  • Reviewer validation before final submission
  • Reduced administrative work
Connected Workflow

How ClinIntel Works Within PAHub

01
Clinical Documents Submitted Supporting documentation enters the PAHub workflow.
02
ClinIntel Analyzes and Extracts Evidence AI identifies relevant clinical information.
03
Questions Answered by ClinIntel Responses are pre-populated for reviewer consideration.
04
Reviewer Validates and Decides Clinical staff retain control of the final determination.
05
Faster, More Efficient Authorizations Less administrative effort supports higher productivity.
One-Month Production Results

Strong performance across multiple drug therapies

ClinIntel delivered an overall 88% completion rate and 83% AI answer acceptance across the enabled questions measured during the study period.

Study period: June 10, 2026 through July 10, 2026. Completion rate, AI answer acceptance, and human intervention reflect enabled questions only. Some questions may be disabled based on product configuration.
Weight Loss 91% Completion 84% Acceptance
Diabetes 87% Completion 80% Acceptance
Immunologicals 81% Completion 89% Acceptance
Inflammatory – Adalimumab 83% Completion 92% Acceptance
Inflammatory – Siliq & Skyrizi 79% Completion 88% Acceptance
Completion Rate AI Answer Acceptance
See ClinIntel in Action

Ready to transform prior authorization reviews?

ClinIntel, a feature within PAHub, uses AI-powered clinical data extraction to reduce manual effort, accelerate reviews, and help health plans and PBMs scale prior authorization operations with confidence.

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*Human intervention includes user corrections and completion of unanswered questions. Results reflect the ProAct study period and enabled question configuration.

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