prior-authorizations

Anthem, Epic strike data exchange partnership

The EHR giant will integrate its payer platform with the insurer’s operating system to facilitate two-way data exchange with providers. Through this integration, the organizations hope to support clinical decision-making and streamline administrative processes like prior authorizations.

CMS proposed rule requires payers to streamline prior authorizations

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The rule would require payers in the Medicaid, CHIP and QHP programs to build and maintain application programing interfaces to improve data exchange and the prior authorization process. But the rule does not include Medicare Advantage plans, which the American Hospital Association called “disappointing.”