Authorizing Radiology Services for Insurance Companies Using Neural Networks

Scott Perry is the Director of Medical Informatics at MedSolutions, a National Radiology Benefits Management (RBM) company. MedSolutions provides authorization for radiology services (e.g. MRI, CT, etc.) for insurance companies serving over 25 million client members across the United States. Mr. Perry attended East Tennessee State University where he obtained his B.S. in Computer Science.

Mr. Perry has been using NeuroSolutions (Developers) along with the Custom Solution Wizard (Developers) for nearly 4-years. In using these products, Mr. Perry has integrated NeuroSolutions neural networks using the Custom Solution Wizard DLL's into MedSolutions proprietary software in helping to determine whether to approve or further review authorization for radiological services. MedSolutions software currently contains 40 neural network classification models, each used to correspond to a related radiological service (e.g. MRI) and specific body part (e.g. Abdomen). They are in the process of adding another 60 neural network models to cover other authorization services they offer at MedSolutions.

Each model is a Multi-Layer Perceptron based on the default parameters used in the NeuralBuilder with exception to the Step Size being reduced by 90%. The model uses roughly 100,000 records extracted from a SQL database using a custom tool they've developed internally and then divided into 70% Training, 20% Cross Validation and 10% Testing data sets. After being trained, the models are then analyzed using the Sensitivity about the Mean and accuracy of classification. Majority of the neural network models provide an error rate as low as 1%!

Using NeuroSolutions' neural networks the response time for most authorizations has improved to minutes, which has reduced their internal cost. Mr. Perry had no problem choosing NeuroSolutons as other competitive products "were more expensive" and the "Custom Solution Wizard DLL option was royalty free". When asked about what he liked best about NeuroSolutions, he said it that the "defaults work and if [he] wanted to stray off the beaten path, it could do it." We would like the thank Mr. Perry for sharing his great success story with us and we hope to continue to see great things from Mr. Perry and MedSolutions in the near future!

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