Raheel Retiwalla

But when I think about the application of AI today,

from a maturity standpoint, health plans and health systems have so much inefficiencies just in the way they do things today themselves and how they run their business.

It's like saying how you ran your business in the sense how you run this podcast.

If it was so inefficient, what's the point of sharing stuff with other people?

You can't even get your own house running correctly and efficiently first.

So what I'm saying is that there's an opportunity to clean up stuff, make yourself more efficient while there are regulations already in place.

demanding the level of interoperability.

So that's going to happen anyway.

Let's start cleaning our house so we are able to benefit from that interoperability and data sharing when it becomes a mandate, when people are seriously doing it.

And it's happening and it's going to happen soon as well.

Yeah, I think the fundamental vision that we share with our health plan clients is very simple.

You've got rules that are blocked, drives inconsistencies and how people make decisions, which drives inefficiencies, costs, and that's what we're trying to produce.

So what we work with them on is identifying specifically the document types that are, you know, that are locking up those rules.

Medical policies is a really good example.

You unlock a medical, what is in a medical policy?

Very simple.

When will the plan, you know, pay for a procedure?

When will it not?

What are those rules that somebody has to follow?

One of the things that we do when you unlock a medical policy is you open up tons of opportunity for automation.