Industry · Healthcare
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Healthcare

Prior authorisation acceleration, utilisation management, patient journey orchestration, clinical document triage on Pega GenAI and Kore.ai.

5.2d
Prior auth cycle live
24/7
AI member support · Kore.ai
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Use cases from Pega · Kore.ai · AWS

Healthcare use cases — from Pega, Kore.ai & AWS

Proven AI patterns for healthcare enterprises — sourced from Pega, Kore.ai, and AWS production deployments. Novitates implements these inside your governed platform.

Pega

Pega — Prior Authorisation Acceleration

AI-accelerated prior auth review. GenAI clinical document triage. Pega reduces prior auth from 14+ days to 5.2 days average. Rules-based auto-approval for standard cases. HIPAA-compliant audit trail.

14d → 5.2d live
AWS

AWS HealthScribe — Clinical Documentation AI

HIPAA-eligible AWS service. Automatically generates clinical notes by analysing patient-clinician conversations. Deployed inside healthcare clients' AWS tenancy. Note generation in real-time.

HIPAA-eligible, real-time
Kore.ai

Kore.ai — Healthcare Member Services AI

Fortune 500 healthcare org serving 12M+ members: Kore.ai unified automated self-service and human-assisted engagement. Composable architecture. Enterprise-grade security for regulated healthcare.

12M+ members served
AWS

AWS GenAI — Healthcare Payer Member Experience

AWS GenAI enhances member experience with intuitive interface, reduces call volumes and operational costs for healthcare payers. Real World Data queries via natural language to SQL.

Call volume ↓ + cost ↓
Pega

Pega — Utilisation Management & Care Coordination

Concurrent review, discharge planning, length-of-stay optimisation inside Pega. AI copilots surface recommendations. Human clinician retains decision authority. Complete case audit for accreditation.

HIPAA audit-by-design
AWS

AWS IDP — Clinical Document Triage

GenAI IDP processes clinical notes, lab results, imaging reports, insurance forms. Natera uses Amazon Bedrock + Textract to extract data from clinical documents. Near-human accuracy at scale.

Near-human accuracy
Kore.ai

Kore.ai — Healthcare Contact Centre AI (24/7)

AI-powered healthcare assistant improving patient and provider experiences. Appointment scheduling, medication reminders, patient intake, 24/7 symptom support. Kore.ai: 77% consumers value 24/7 access.

24/7 patient support
Pega

Pega — Provider Credentialing & Enrollment

Credentialing workflow automation inside Pega. Document collection, primary source verification, state licensing tracking. GenAI document triage reduces credentialing from weeks to days.

60% faster credentialing
AWS

AWS — Clinical Trial Protocol GenAI

GenAI streamlines clinical trial protocol development — integrates data from multiple sources, suggests study designs, incorporates regulatory guidelines. Natural language search of clinical data.

Months → weeks

Use cases sourced from Pega, Kore.ai, and AWS published documentation. Novitates implements these patterns inside your enterprise environment on Pega and Kore.ai.

Why Novitates for Healthcare

BFSI-native. Platform-deep. Outcome-based.

Platform-native AI

Pega and Kore.ai — not generic AI tooling bolted onto your stack. Every AI decision logged in the platform's native audit trail. No additional logging infra.

Outcome-based commercials

Fixed-outcome engagements. Per-transaction pricing. 20% held in escrow against delivery. We share commercial risk with you on every engagement.

Inside your perimeter

Your AI licence. Your data residency. Your tenancy. We engineer inside your approved security boundary — your CISO doesn't need to approve a new vendor.

Production proof · Not projections

Live outcomes from the field.

Every metric below is contractually committed and verified in production — not pilot projections or analyst estimates.

Insurance · Claims AI · Pega CS
Top-10 global insurer — FNOL triage on Pega Customer Service
3.4d
Claims cycle (from 9d)
62%
Cycle time reduction

GenAI document triage + fraud-aware decisioning. Sub-15-minute FNOL intake. Regulator-grade audit trail on every AI decision.

Banking · CLM · Pega CLM
Amicorp Group — OBEC compliance copilot inside Pega CLM
62%
Reviewer time saved
100%
Audit coverage

KYC remediation + beneficial ownership reasoning inside Pega CLM. Multi-jurisdiction compliant. Every agent action logged.

Insurance · Underwriting · Pega
IFFCO Tokio — Underwriting & health-claims copilot
41%
Auto-decisioned
↓65%
Review time

Multi-line underwriting AI — health, motor, property. IRDAI-aligned governance. Human decision point on all exceptions.

30 minutes. No deck. No pitch.

A working session with an AI strategist and a senior engineer. We'll sketch how your problem ships — architecture, models, controls, and a 90-day path to a measured outcome.