Determining Prior Authorization Approval for Lumbar Stenosis Surgery With Machine Learning.

Amaury De Barros^1,2, Frederik Abel³, Serhii Kolisnyk⁴, Gaspere C Geraci⁵, Fred Hill⁵, Mary Engrav⁵, Sundara Samavedi⁵, Olga Suldina⁶, Jack Kim⁵, Andrej Rusakov⁵, Darren R Lebl³, Raphael Mourad^5,7

¹Toulouse NeuroImaging Center (ToNIC), University of Toulouse Paul Sabatier-INSERM, Toulouse, France.

²Neuroscience (Neurosurgery) Center, Toulouse University Hospital, Toulouse, France.

³Hospital for Special Surgery, New York, NY, USA.

⁴Vinnitsa National Medical University, Vinnytsia, Ukraine.

⁵Remedy Logic, New York, NY, USA.

⁶Cadabra Studio, Dnipro, Ukraine.

⁷University of Toulouse, Toulouse, France.

PubMed PMC DOI PDF

Abstract

STUDY DESIGN: Medical vignettes. OBJECTIVES: Lumbar spinal stenosis (LSS) is a degenerative condition with a high prevalence in the elderly population, that is associated with a significant economic burden and often requires spinal surgery. Prior authorization of surgical candidates is required before patients can be covered by a health plan and must be approved by medical directors (MDs), which…

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