HIT Consultant September 19, 2024
The critical need to improve prior authorization processes might have reached its tipping point on Jan. 17. That’s when the Biden administration announced its new mandate — the CMS Interoperability and Prior Authorization Final Rule — designed to effectively speed up the process for Medicare Advantage patients, providers and health plans.
Speed is only one of many inefficiencies surrounding prior authorization. And prior authorization cases are only one slice of the patient population whose cases are reviewed annually by insurers. A movement is underway to streamline authorization processes — and not just prior authorization — using 21st-century tools to guide human decision-making along the way.
New legislation, new tools, new standards
The Final Rule requires certain payers, including Medicare Advantage...
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