AI Prescription Prior Authorization Validation Patent Application
Summary
The USPTO has published a patent application (US20260088148A1) detailing an AI-based method for validating prescription prior authorization documentation. The application, filed on September 19, 2025, describes a system that uses machine learning to analyze documentation and determine authorization approval or rejection.
What changed
The United States Patent and Trademark Office (USPTO) has published a patent application, US20260088148A1, related to an "ARTIFICIAL-INTELLIGENCE-BASED PRESCRIPTION PRIOR AUTHORIZATION VALIDATION" system. The application outlines a computerized method that analyzes prior authorization documentation using machine learning models to extract request data, compare it against authorization criteria, and subsequently approve or reject the authorization request. This filing represents a novel technological approach to streamlining the prior authorization process.
While this is a patent application and not a regulatory rule, it signals potential future technological advancements that could impact healthcare providers and pharmaceutical companies. Compliance officers should be aware that such AI-driven systems may become more prevalent, potentially affecting workflows for prior authorization processing. The application was filed on September 19, 2025, with a publication date of March 26, 2026.
Archived snapshot
Mar 26, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
ARTIFICIAL-INTELLIGENCE-BASED PRESCRIPTION PRIOR AUTHORIZATION VALIDATION
Application US20260088148A1 Kind: A1 Mar 26, 2026
Inventors
Christopher R. Markson, Pritesh J. Shah, Abbai Manyam, Urvashi Patel, Akash Dwivedi
Abstract
A computerized method for analyzing prior authorization documentation includes receiving a first set of information including a set of pages and determining a set of relevant pages. The method includes determining a set of document types associated with the set of relevant pages and performing optical character recognition. The method includes prompting a machine learning model to extract a set of request data. The method includes prompting the machine learning model with a set of prompts associated with a set of authorization criteria to determine a set of authorization data. The method includes, in response to a determination that the set of authorization data has met the set of authorization criteria, approving an authorization request. The method includes, in response to a determination that set of authorization data has not met the set of authorization criteria, rejecting the authorization request.
CPC Classifications
G16H 20/10 G06V 10/751 G06V 30/19013 G06V 30/30 G06V 30/416 G06V 30/418 G06V 30/42 G16H 10/60
Filing Date
2025-09-19
Application No.
19334095
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