WEDI Spotlight: Automated Prior Authorization in Real Time for Payers & Providers


Presented by Maxim Abramsky,

AVP of Prior Authorization Product Management at Edifecs

Prior authorization is one of the last unautomated business processes, yet one of the largest burdens on providers. This has resulted in costly business processes, delayed care, and suboptimal health outcomes. All that is about to change with evolving legislation and technology. By leveraging AI/NLP, X12 278/275, FHIR® standards, and EHR integration, the path to real-time automated prior authorization from the provider’s EHR to the payer’s utilization management is finally within grasp.
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