In a future state, the automation of prior authorization decisions would be a natural element of high quality, value-based care. After all, the goal of prior authorization is to ensure that a member’s ...
"Bringing pre-authorization to the point of care" reduces burden across stakeholders, notes one Regence executive. Regence—a Blue Cross Blue Shield Association plan offering commercial, exchange, and ...
The partnership combines Abridge’s conversational AI platform with Availity’s FHIR-native Intelligent Utilization Management ...
Abridge, which serves more than 200 health systems, is projected to support over 80 million patient-clinician conversations ...
Pacific Northwest insurer Regence is teaming with MultiCare Connected care to roll out a new tool that aims to ease the administrative burden of prior authorization. Regence and MultiCare, an ...
Beyond voluntary promises, standards and a federal mandate for FHIR-based APIs create a powerful framework for real prior authorization reform and broader interoperability. The recent voluntary pledge ...
The Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F) sets a new standard for how payers exchange data and respond to authorization ...
One increasingly subtle but important theme in US healthcare is the shift to care allocated by payers rather than providers. Historically, decisions on what care to provide patients were made by ...
BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company, today announced a new solution that fully automates prior authorization at the point of care, ...
A pair of recent announcements from the U.S. Department of Health and Human Services show agencies working to help providers and payers reduce their data exchange burdens and enable Medicare enrollees ...
WASHINGTON, D.C. / ACCESS Newswire / December 15, 2025 / The healthcare payer information technology (IT) sector continues to evolve rapidly, and 2026 is positioned to be a pivotal execution year for ...
Before working to create standards for electronic prior authorization, the entire process itself needs some work. That was the message from groups representing physicians, medical practices, and ...
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