How Health Plans Are Achieving Payer-Provider Interoperability Through Bidirectional Data Exchange

Efforts to transform prior authorization are at a critical crossroads: Will regulatory mandates result in just compliance or catalyze national migration to FHIR-based electronic prior authorization? The answer to this question cannot be found in the specifics of CMS-0057-F but instead resides in the level of trust between health plans and their network providers. There is a compelling ROI for plans, but only if providers jettison ingrained workflows and embrace this new approach.

In this on-demand webinar, experts from InterSystems and WEDI examine what health plans need to do to move beyond regulatory compliance and drive widespread provider adoption of electronic prior authorization.

Drawing on insights from approximately 150 payer, provider, policy, and technology stakeholders, the speakers explore the minimum functionality an electronic prior authorization solution needs to succeed across seven critical areas.

• What CMS-0057-F means for health plan prior authorization strategies
• Why technical compliance alone may not lead to provider adoption
• How EHR integration can make electronic prior authorization easier to use
• What providers expect from questionnaire turnaround, information retrieval, and response reliability
• How health plans should prioritize lines of business and covered services
• Why a carefully planned soft launch can improve adoption and reduce implementation risk
  

Steven Berkow, Head of Value-Based Care Market Strategy, InterSystems
Robert Tennant, Executive Director, WEDI