Highmark Health and Abridge Partner to Transform Clinical Documentation and Prior Authorization
Highmark Health has announced a wide-scale collaboration with Abridge, a Pittsburgh-based developer of AI technologies for healthcare, to integrate AI-driven clinical documentation and real-time prior authorization into its payer-provider ecosystem. The agreement spans both Highmark’s insurance division and its care provider network, Allegheny Health Network (AHN), which operates 14 hospitals across multiple states.
AI-Powered Clinical Documentation Across AHN
The first step in this initiative is the deployment of Abridge’s ambient clinical intelligence platform in AHN hospitals and outpatient offices. This system captures patient-clinician conversations—with patient consent—through secure devices and generates real-time clinical notes within the clinician’s existing workflow. Providers can review, edit, and submit these notes directly into the patient’s electronic health record (EHR).
By automating what is traditionally a manual process, the platform enables providers to focus more fully on patient interaction rather than typing into a computer. AHN’s pilot program with this technology reported that 92% of patients felt their provider was more attentive during visits when the system was in use. Clinicians also reported significant reductions in after-hours charting, known in the industry as “pajama time.”
Planned Expansion Across Care Settings
While the rollout begins in outpatient practices, AHN intends to expand the technology across its full footprint, including emergency departments, inpatient units, and home care. Physicians, advanced practice providers, and nurses will all have access to the platform once deployment is complete.
Streamlining Prior Authorization at the Point of Care
Beyond documentation, the partnership will advance a real-time prior authorization solution. Prior authorization is the process of obtaining insurance approval before a service or prescription is provided. Delays often occur when required clinical details are missing at the time of submission.
Highmark Health has been refining its electronic prior authorization capabilities through initiatives like its Gold Carding program, which pre-approves physicians with strong practice histories. The new Abridge integration will take this further by identifying missing documentation during the patient encounter itself. Clinicians will be prompted to collect the necessary details before the appointment concludes, enabling immediate or near-immediate approval.
Impact on Patient Care
This approach is designed to reduce delays in care, lower the administrative burden on physicians, and decrease denial rates caused by incomplete information. Physicians remain in control, reviewing all AI-generated recommendations before final submission. Both organizations view this as a way to align insurer and provider expectations in real time, shortening the approval process from weeks to minutes.
Commitment to Innovation in Western Pennsylvania
The collaboration also highlights both organizations’ investment in making Western Pennsylvania a hub for health technology development. Highmark Health’s tech subsidiary, enGen, will be involved in enabling and scaling these AI-driven solutions.
According to Highmark Health’s Chief Analytics Officer, Richard Clarke, PhD, integrating AI into the Living Health model aligns with the company’s mission to improve efficiency, affordability, and patient experience. By combining Abridge’s technology with Highmark Health’s infrastructure, the organizations aim to create a more connected and responsive healthcare system.
The rollout of ambient documentation and real-time prior authorization at scale could represent a shift in how health systems address clinician workload and patient access to timely care. If successful, it may become a model for other integrated payer-provider organizations seeking to streamline both clinical and administrative workflows.