AHIMA August 3, 2020
Imagine a world where health information management teams know in advance the documentation a payer needs to authorize an admission or conduct a medical necessity review, their IT systems populate the needed data for them to verify, and the documentation is then sent electronically to the right place within the payer organization for a timely decision.
Increasingly, policymakers and industry experts are trying to tackle the burdensome processes currently in place when clinical and administrative data come together, with an initial focus on prior authorization. This includes work being done by the Centers for Medicare and Medicaid Services (CMS), the Office of the National Coordinator for Health IT (ONC), and the National Committee on Vital and Health Statistics (NCVHS) to...