Prior Authorization Automation: Opportunities and Landmines
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Wednesday, May 10, 2023
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11:15 am – 12:15 pm
Within the past 30 months, there has been a flurry of regulatory activity in the United States related to prior authorizations and interoperability. This activity represents an industry-wide desire to leap forward, with many of these regulations even referencing specific standards as the desired solution. In the meantime, the “old problems” with prior authorization (too many faxes and phone calls, too little information available at the time of clinical decisions, and utilization reviews taking an inordinate amount of clinician time) continue to become more burdensome for patients, providers, and health plans. This session will focus on the technological areas where health IT industry stakeholders have chosen to focus their resources to automate and inform clinical decision-making, which are rules engines that help automate prior authorizations and novel uses of artificial intelligence (i.e., machine learning) to improve efficiency in clinical workflows. In addition, the speakers will illustrate how health IT professionals can leverage the urgency of regulatory activities and market-led conditions in tandem with new technology to solve critical challenges around prior authorizations.
Track Session Speakers
- Daniel Cawood
- Product Manager, Interoperability Solutions
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- MCG Health
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