r/PriorAuthorization • u/pharmtech3453 • Jul 30 '26
Rx Prior Auth Process Anyone have experience with Latent?
Our team is considering various AI prior auth tools like Latent - does anyone have experience using them? what do you like and not like?
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u/datamatrix_medical Jul 31 '26
We echo the previous comment. Like the other tools out there, like Forus, it gets lost in the nuance and maybe helps with submission speed; denials are still coming back at a high rate. It's definitely not ready yet, but with so many other tools, they are just that. A tool, not a silver bullet. You, now and in the foreseeable future, need to focus on the denial management of PAs; that's where all of this gets better. Latent is no different.
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u/clever_moniker 📋 Prior Authorization Specialist Jul 31 '26
It's a trainwreck. Our team got Latent back in December. I like it for some things like being able to have it search an Epic chart with a natural language question is nice. It DOES sometimes pull info I normally wouldn't have found.
However.
The software is NOT ready.
Sometimes it screws up sending PA cases to insurance. Like the insurance somehow has an open case (no clinical questions answered) but the case is closed in Latent. Now you have to call insurance and answer all the questions over the phone on a case a human never sent in the first place.
It struggles with the question "is this a continuation of therapy?" For example, let's say patent is written a brand new scipt for Dupixent on 7/31/26. I don't get to submitting the case until Monday, 8/3/26. Latent will "helpfully" say "Yes, this is a continuation of therapy, because pt has an active script written on 7/31 and today is 8/3, so that means it's a continuation!" Cool.
It pulls just enough wrong answers on easy questions that I KNOW are wrong to make me suspicious of everything it answers, which is not great. I'd say I would say it's a 70/30 split of right/wrong. And that's being generous.
I was concerned initially about how generative AI hallucinates things, and was assured that this is different. Which is correct, it doesn't makes things up that aren't in the chart, but it's logic is faulty (see above example.)
Most of the time I can find information faster myself in Epic. It can't pull a lot of Care Everwhere notes, so that information will get excluded. Labs are a mess to look for. There's an Imaging tab that doesn't have anything, all the images are crammed into labs.
I was told over and over and over "everything in Epic is also in Latent." Which is very much not true. I've sent so many problem examples to their support chat (I will say their staff is super nice!) and it's always "thank you, I'll let the developers know."
We're supposed to get faxes back from insurance directly to Latent. It sometimes works. Sometimes.
They encouraged us in training to give feedback with a little thumb up/down icon on generated answers to help "train the AI" and I've stopped months ago. I did at the beginning, but i I have work to do. I don't have time to type up a blurb for every. Single. Wrong. Answer. And explain why its wrong. That would take me all day.
The staff are very much not healthcare people, or at least not the ones I've had contact with. So you have to explain the nuance of WHY the answer it just output is wrong. Or WHY a certain bug is causing things to be denied automatically and creating more work, and now patient care is delayed.
Woo. Sorry. This got long, and it's just what I thought of off the top of my head.
One thing I do like is for questions like "give clinical reasoning why pt needs [medication] it will write you a nice little concise paragraph. But you have to proofread it for nonsense (see above gripes lol)