Lifestyle

Healthcare Leader Avantika Sharma Reveals How Digital Tech Solutions Can Improve Prior Authorization Procedures

Published

3 years ago

January 25, 2023

One of the most necessary and standard procedures in the healthcare industry is Prior Authorization (PA), which requires healthcare providers to obtain approval for a treatment or medication before delivering it to a patient. Unfortunately, PA is also one of the most inefficient processes in the healthcare industry and is currently facing a crisis.

This year, 70% of medical groups attested that PA claims increased, yet, at the same time, a study by the University of Colorado found that 93% of providers reported delays in care due to drawn-out PA processes. In short, claims are increasing, and one of the side effects is that delays are becoming more notable, if not longer. This is due to long-standing inefficiencies and problems swept under the rug for years, resulting in longer patient waiting times, increased burden on administrative staff, and even physician and clinician burnout.

At Brillio One Health, Healthcare Leader Avantika Sharma and her team are working towards streamlining and optimizing healthcare systems like PA to benefit healthcare providers, insurance payers, and, of course, patients. They work with international healthcare organizations to “covert digital disruptions into solutions that can position payers and providers ahead of the curve.”

She views the current workflow required to obtain PA for a procedure or treatment to be an area that requires extensive digital reform. According to Sharma, “technologically automating the Prior Authorization process at the level of providers and payers can drastically improve the patient experience by getting on-time approvals before surgery and reducing operational and administrative costs.”

The PA process is currently plagued by administrative complexities, time-consuming manual procedures, liabilities due to human error, and excess use of valuable resources. To illustrate, most documents are faxed or emailed and require physical signatures, even though the digital resources to replace those aspects of the process are well established. Not to mention using manual technologies to transmit documents has already been proven to be more likely to lead to incorrect information, missing documents, and excessive back-and-forth communication.

All that communication is done by large teams of administrators, who spend considerable time sorting and verifying numerous documents from different sources. This puts a huge burden on hospitals and insurance companies to staff those teams accordingly. It also contributes to complexity and redundancy on an administrative level.

There are also confidentiality issues that come with using manual systems to complete PA claims. According to Sharma, “using fax to transmit prior authorization forms minimizes the legal requirement to keep medical information confidential since it involves the production of a printed piece of paper that can be easily seen or taken by anyone walking past the machine when it prints or someone’s desk where it is awaiting processing.”

Even more alarming is the lack of coordination between the systems used by payers and providers. Despite the amount of communication required between these two entities to get a single claim passed, the current systems can vary from one organization to another. For example, 15 different providers might use 15 different websites, each with unique software and login information.

Sharma believes that adopting digital solutions on the part of providers and payers could result in major improvements in the PA process. Brillio’s human-centric approach includes the design and implementation of systems powered by Artificial Intelligence (AI), Machine Learning (ML), and Natural Language Processing (NLP), among other technologies. These innovative systems are already present in our daily lives but can be combined to create efficient, constantly evolving solutions that benefit the healthcare industry.

Proposed solutions would certainly include the creation of standard systems for communication between payers and providers. An example of this is online portals and digital software that is standardized across all platforms. Optimizing this software would allow relevant personnel from both the medical and the insurance side to use their secure username and password to access the same PA documents, at different stages of the process. Other solutions might be using NLP to convert doctors’ notes into text compatible with online forms or using AI to develop approval processes for documents, thereby cutting down on the administrative staff needed to verify every signature or document in a PA claim file. Using electronic signatures, electronic health records (EHR), and opting for digital file sending are all essential solutions as well.

These solutions would be one piece in a larger movement that could radically change the healthcare industry in the United States. One rule introduced in early December 2022 by the Centers for Medicare and Medicaid Services included the implementation of electronic PA processes for document attachments and signatures. It also included the required adoption of a Health Level 7 (HL7) Fast Healthcare Interoperability Resources FHIR standard Application Programming Interface to support new digital systems. CMS predicted that implementing better digital systems, alongside other proposed solutions, for PA could save more than $15 billion over 10 years.

Most importantly, Sharma highlights the importance of putting the patient first. Lengthy PA processes can take days, if not weeks, to go through, and only a tiny fraction of them are approved without delays. Most PA claims are denied at the outset and require appeals and negotiation. A patient-centric healthcare system focuses on making sure sick people are given the care they need, when they need it, without waiting for their doctors and insurance providers to jump through hoops.

For more information, visit www.brillioonehealth.com.

Lifestyle

How Scamless Helps Families Protect Elderly Parents From Online Scams

Published

7 days ago

July 14, 2026

Matthew Wiles

(Image credit: Scamless)

To protect elderly parents from online scams, families should combine regular communication, scam-awareness education, verification habits, and real-time scam detection tools. Scamless helps by detecting suspicious messages, phishing links and impersonation attempts across WhatsApp, SMS, Instagram, Facebook Messenger, X and TikTok before users click, reply or send money.

Why Seniors Are Targeted by Online Scams

Online scams have become a growing concern for families, particularly when it comes to protecting elderly parents who increasingly rely on digital communication for banking, healthcare, and staying connected. As scam tactics become more sophisticated, many families are searching for ways to protect elderly parents from scams, explore scam protection for seniors, and find reliable tools, such as a senior fraud prevention app or family scam protection app that can provide real-time safety across messaging platforms.

Scamless is an AI-powered scam detection app that helps users detect suspicious messages, phishing links and impersonation attempts across apps such as WhatsApp, SMS, Instagram, Facebook Messenger, X and TikTok before they click, reply or send money.

Arjun Singri, founder of Scamless, explains that the vulnerability of seniors is not linked to awareness or intelligence, but to the evolving nature of digital manipulation. “The challenge is that scams are designed to blend into everyday communication,” he says. “They appear as normal messages, often from sources that feel familiar and trustworthy.”

Common Scams Targeting Elderly Parents

Scammers frequently target older adults through emotional and time-sensitive messaging. These include fake bank alerts, impersonation of family members, delivery notifications, and urgent account security warnings. Each message is structured to create urgency and reduce the likelihood of verification. Singri notes that this emotional pressure is central to how fraud succeeds. “When urgency enters the conversation, people tend to act before they validate,” he says.

One of the most common risks involves impersonation scams, where attackers pretend to be a relative or a trusted institution. These messages often request immediate financial assistance or sensitive information. In many cases, they are delivered through messaging platforms where conversations feel private and personal, making detection more difficult.

Another frequent category includes fake bank texts and account alerts. These messages claim that accounts have been compromised or transactions require immediate verification. They often contain links that lead to fraudulent login pages designed to capture credentials. Delivery scams and fake shopping notifications also remain widespread, especially during periods of high online purchasing activity.

Singri explains that these patterns are intentional and highly structured. “Scams are not random messages,” he says. “They are carefully designed interactions that guide someone toward a decision without giving them time to question it.”

For families, this creates a unique responsibility. Protecting elderly parents from scams is no longer limited to education alone. It requires ongoing support and systems that can assist in real-time as threats appear. Caregivers often play a critical role in helping seniors identify suspicious messages, verify requests, and avoid rushed decisions.

However, human oversight alone has limitations. Messages can arrive at any time, and scams often unfold within seconds of engagement. This is where technology becomes an important layer of protection.

How Scamless Supports Family Scam Protection

Scamless operates as a scam protection app for seniors and a family scam protection app designed to help detect suspicious messages, phishing links, and impersonation attempts across platforms such as WhatsApp, SMS, Instagram, Facebook Messenger, X, and TikTok. It functions as a senior fraud prevention app by analyzing communication in real time and flagging potential risks before action is taken.

The system identifies patterns associated with manipulation, including urgency cues, unusual requests, and inconsistencies in sender behavior. When a risk is detected, it provides real-time scam alerts that explain why a message may be unsafe. This allows both seniors and family members to understand the context of the threat rather than relying on uncertainty.

Why Real-Time Scam Alerts Matter for Seniors

Singri emphasizes that clarity is a critical part of protection. “People do not need more fear,” he says. “They need understanding at the moment a decision is being made.”

One of the key advantages of using a family scam protection app is shared awareness. Families can support each other in identifying suspicious communication patterns and reinforcing safe digital habits. This creates a collaborative approach where protection is distributed across both technology and human support.

Caregivers often look for tools that reduce friction for seniors while still offering strong protection. Scamless is designed to integrate into everyday communication without requiring additional steps from the user. It helps users check suspicious messages before clicking, replying, or sharing sensitive information, reducing the risk of accidental engagement with fraudulent content.

Singri explains that timing is often the deciding factor in whether a scam succeeds. “Most scams succeed in moments where someone feels pressured to respond quickly,” he says. “If that moment is interrupted with clarity, the outcome changes.”

Scam protection for seniors must also account for emotional factors. Older adults may be more trusting of messages that appear to come from family members or institutions they have interacted with for years. Scammers exploit this trust by replicating tone, branding, and communication style. This makes detection especially difficult without additional support systems.

How AI Helps Detect Senior Fraud Attempts

AI plays an increasingly important role in addressing this challenge. Scamless uses machine learning to analyze large volumes of communication data and identify patterns that may indicate fraud. It adapts continuously to new scam techniques, ensuring that protection evolves alongside emerging threats.

The platform also helps reduce dependency on manual verification. Instead of expecting seniors or caregivers to assess every message, it provides immediate analysis that highlights potential risks in context. This is particularly important in situations involving fake bank texts or urgent family requests, where hesitation is often overridden by emotional response.

Singri frames this as a shift in how digital safety is understood. “Protection should not depend on constant vigilance,” he says. “It should be built into the environment where communication happens.”

Families using scam protection tools benefit from reduced stress and increased confidence in digital interactions. Seniors gain reassurance, while caregivers gain visibility into potential risks without needing to monitor every conversation directly.

Scamless and the Future of Senior Scam Protection

The rise in scams targeting older adults reflects broader changes in communication behavior. As more daily activities move online, including banking, shopping, and healthcare coordination, the number of potential entry points for fraud increases. Scammers take advantage of this expansion by designing messages that mirror legitimate interactions.

Singri notes that this evolution requires a new approach to safety. “The environment has changed faster than people expect,” he says. “That gap is where scams find opportunity.”

Scamless addresses this gap by embedding detection directly into communication channels, allowing risks to be identified as they appear. This approach helps ensure that seniors are not left to interpret complex signals on their own, especially in high-pressure situations.

For families seeking to protect elderly parents from scams, the combination of awareness, communication, and intelligent support systems offers the most effective path forward. Education remains important, but it becomes significantly stronger when paired with real-time protection.

As digital communication continues to expand, the need for accessible and adaptive safety tools will only grow. Scam protection for seniors is no longer a secondary concern. It is a central part of maintaining trust and independence in a connected world.

For Singri, the mission is grounded in simplicity and timing. “The right support at the right moment can prevent everything that follows,” he says. “And sometimes, that moment is all that stands between safety and loss.”