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Brevor.
CARESOURCE
Health payers · 2023

$8.2M annualized operating savings.

Bridge Workspace plus the Bridge Context Health module deployed across claims pre-authorization. Cycle time dropped from 9 days to 31 hours median, with $8.2M in annualized operating savings reported in the first full year.

THE SITUATION

CareSource is one of the largest non-profit managed care plans in the United States, operating across multiple states with deep concentration in Medicaid and Marketplace populations. Pre-authorization volume had grown 41% over two years, and claims-ops headcount had grown with it.

The pre-authorization team had grown to 89 FTEs across three locations. Adding more headcount was not scalable, and the underlying decision logic was complex enough that simple workflow automation had failed three prior pilots.

Bridge Workspace combined with the Bridge Context Health module was scoped as the deployment. Behavioral routing across the pre-authorization workflow, with Health-module specificity for clinical context.

THE CHALLENGE

Replacing routing FTEs without breaking clinical trust.

CareSource needed to reduce pre-authorization cycle time without introducing audit risk. State insurance regulators required defensible decision trails for every pre-authorization decision involving AI. Member complaints about cycle time were rising. The solution had to ship in a single fiscal quarter.

THE DEPLOYMENT

Eight weeks from scope to scale.

Quarter 1 covered integration with CareSource's existing claims platform and Bridge Context Health module configuration to match state-by-state clinical norms. Quarter 2 saw pilot deployment across 14% of pre-authorization volume. Quarter 3 scaled to 100% with median cycle time at 31 hours — an 88% reduction. $8.2M in annualized operating savings was reported in the first full year post-deployment.

RESULTS

Eight-week measured outcomes.

$0M
Annualized operating savings
First full year post-deployment
0%
Reduction in cycle time
From 9-day to 31-hour median
0%
Pre-authorization volume
Routed through Bridge Workspace
0
Audit findings
Across full deployment year
The audit trail is what got this past our state regulators. Without it, we couldn't have deployed AI in pre-authorization at all. Bridge gave us the trail by default, and the cycle-time reduction came with it.
CARESOURCE
Director, Claims Operations
PRODUCTS DEPLOYED

What CARESOURCE runs in production.

Bridge Workspace
Behavioral layer for enterprise AI deployments.
View Bridge Workspace
Bridge Context
Cultural and jurisdictional modules for the behavioral layer.
View Bridge Context
Bridge Health
Behavioral context tuned for clinical environments.
View Bridge Health

Scope a deployment like CARESOURCE's.