Tag: electronic prior authorization (ePA)

Prior Authorization Burden

9 Ways to Ease the Prior Authorization Burden and Reclaim Your Time

Prior authorization (PA) is a necessary but often frustrating part of the healthcare reimbursement process, and the prior authorization burden it creates is substantial. While insurers use it to manage costs and ensure medical necessity, the administrative burden it places on physicians, billing staff, and patients is immense. A 2022 American Medical Association (AMA) survey […]
FHIR-based ePA

Mastering CMS Rule 0057: Optimizing FHIR-Based ePA for Health Plans

The CMS Rule 0057 mandates that health plans develop and support FHIR-based APIs to facilitate FHIR-Based ePA. Whether this investment merely ensures compliance or unlocks broader benefits such as improved provider experience, enhanced efficiency, and streamlined operations depends on strategic planning and collaboration rather than cost alone To assist health plans in addressing these critical […]