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Video: Adopting a FHIR-based approach to Prior Authorization, Presented by InterSystems

Knowledge Center Video: Adopting a FHIR-based approach to Prior Authorization, Presented by InterSystems August 31, 2023 With the currently proposed CMS rule, 0057-P, Advancing Interoperability and Improving Prior Authorization Processes, improving this process has become a hot topic. Yet, looking across the industry, there are still many bespoke solutions that don’t solve for the scalability…

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Podcast Episode 117: Breaking Down the Silos on the Way to Achieving Interoperability – A Conversation w/ Darena Solutions CEO Pawan Jindal, MD

Knowledge Center Podcast Episode 117: Breaking Down the Silos on the Way to Achieving Interoperability – A Conversation w/ Darena Solutions CEO Pawan Jindal, MD August 25, 2023 Michael chats with Dr. Pawan Jindal, MD, CEO of Darena Solutions, a St. Louis-based tech company that delivers EHR and other health IT solutions for vendors and…

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Video: 275 (and 277 RFAI) Early Adopters

Knowledge Center Video: 275 (and 277 RFAI) Early Adopters August 24, 2023 Mary Lynn Bushman, Agile Product Manager, National Government Services Sherry Wilson, Executive Vice President, Chief Compliance Officer, Jopari This session from the 2023 WEDI Summer Forum spotlights the Health Care Attachments for Claims and Prior Authorizations. Mary Lynn and Sherry share early adopters’…

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Congress Proposes Relief on Prior Authorization, but CMS is Ahead of the Game

Knowledge Center Congress Proposes Relief on Prior Authorization, but CMS is Ahead of the Game August 22, 2023 A couple of new bills, or rather, retreads of old bills, demonstrate increased congressional interest in reforming prior authorization (PA) under Medicare Advantage (MA). The Price Transparency bill’s Title III section (“Establishing Requirements with Respect to the…

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August Emerging Tech Meeting with Mike Rapach, President & CEO of CareFirst Health Plan Maryland

Knowledge Center August Emerging Tech Meeting with Mike Rapach, President & CEO of CareFirst Health Plan Maryland August 18, 2023 An important aspect to adopting new technology is to partner and justify projects with senior management. Mike Rapach, President & CEO of CareFirst Health Plan Maryland organization, led this meeting. Originally a very innovative technologist,…

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Solving for Automated Prior Authorization: Three Things You Need to Know

Knowledge Center Solving for Automated Prior Authorization: Three Things You Need to Know August 17, 2023 Written by Maxim Abramsky, AVP Product Management, Edifecs Prior authorization has become increasingly burdensome for patients, providers, and even health plans. Most prior authorization requests are done manually, in a non-standard process that often results in substantial administrative costs,…

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Podcast Episode 115: Data – The Key to Addressing Health Disparities

Knowledge Center Podcast Episode 115: Data – The Key to Addressing Health Disparities August 11, 2023 From a recent WEDI Health Equity Workgroup meeting, a discussion with Mark Megerian, Technology Fellow with Optum. Visit United Health Foundation’s comprehensive data and SDOH tool, America’s Health Rankings (https://www.americashealthrankings.org/) to see some of the work United and Optum…

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Opportunities and Challenges: Moving from ICD-10 to ICD-11

Knowledge Center Opportunities and Challenges: Moving from ICD-10 to ICD-11 August 10, 2023 Written by Robert Tennant, VP Federal Affairs, WEDI Developed by the World Health Organization (WHO), the International Classification of Diseases, 11th Revision (ICD–11) is the international standard for systematic recording, reporting, analysis, interpretation and comparison of healthcare mortality and morbidity data. This…

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The Weekly – August 2023

Knowledge Center The Weekly – August 2023 August 9, 2023 August 7th August 14th August 21st August 28th Subscribe to The Weekly! Back to Knowledge Center Categories Comments & Letters Podcasts Press Releases Regulatory Updates SDOs & Operating Rules Updates Videos WEDI Blog WEDI in the News WEDI Newsletters WEDI Papers & Fact Sheets Recent…

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