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Episode 162: Workgroup Voices, The Inner Workings of Prior Authorization

March 4, 2019

May 20-22 conference will bring health care leaders together across payers, providers, government regulators and industry vendors to discuss critical challenges facing the industry


WASHINGTON, DC — March 4, 2019  WEDI, the nation’s leading nonprofit authority on the use of health IT to create efficiencies in health care information exchange and a trusted advisor to the U.S. Department of Health and Human Services (HHS), today announced that Elise Sweeney Anthony, J.D., Executive Director, Office of Policy at the Office of the National Coordinator for Health Information Technology (ONC) will headline the 2019 WEDI Spring Conference. The event will take place this May 20-22 at the Hyatt Regency La Jolla at Aventine in San Diego, Calif.

Following last month’s announcement at HIMSS that ONC has put forth a proposed rule aimed at supporting the interoperability of electronic health information (EHI), Anthony will join health care leaders from amongst payers, providers, government regulators and industry vendors for an engaging discussion as to what the industry needs to know about the important 724-page document and how this rule will impact patient care. Additionally, in this keynote session, Anthony will share her insights – through her role in leading ONC’s engagement on a range of high-priority federal policy efforts, including regulatory development, information blocking, MACRA implementation, and governance – on a look into the future in terms of possible rules on the horizon.

“As ONC continues to reduce the interoperability burden by proposing a new rule which will enable patients and providers access to health information so better choices can be made when it comes to care and treatment, having Elise Sweeney Anthony, J.D. join us for our Spring event couldn’t be timelier,” said Charles W. Stellar, WEDI president and CEO. “WEDI conferences continue to be critical gatherings that foster great collaboration and networking between a diverse cross-section of some of the top industry thought leaders and influencers. I’m looking forward to the high-level discussions that will take place at our Spring Conference surrounding key issues that are impacting the health care landscape."

Beyond general sessions featuring some of the top influencers in health care, the WEDI Spring Conference will offer attendees dozens of breakout sessions and educational workshops lead by industry experts, including:

  • The Imperatives for Interoperability Standards in the Future of Health Care and Plecosystem Economy – Dr. John Mattison, Chief Medial Information Officer and Assistant Medical Director, Kaiser Permanente
  • The Changing Dynamic in Health Care Security: The risk or the promise? – Charles Aunger, Managing Director, Health 2047
  • NCVHS Update: Recommended Reform for Improved Interoperability – Alix Goss, NCVHS
  • Best Practices for EFT Enrollment Security – Margaret Richardson, EDI Manager, Centene Corporation and Heather Manuel, Vice President, PNC Bank
  • Provider Adjustments (PLB) in the Electronic Remittance Advice (835) – How do they work? – Patricia Wijtyk, Cognizant and Pamela Grosze, PNC 2018 CAQH Index® Findings: Immediate Opportunities to Save Time and Reduce Business Costs – Kristine Burnaska, Director, CAQH Research & Measurement Explorations
  • Delivering More Efficient Prior Authorization and Attachment Electronic Transactions through Operating Rules – Rachel Goldstein, Manager, CORE and Taha Anjarwalla, Manager, CORE
  • Using Analytics to Identify Departures from Medical Coding Standards – Michele Hibbert-lacobacci CCSP, OHCC, Senior Vice President, Regulatory Compliance Management, Mitchell International
  • Value or Cost: Electronic Claim Status Request and Response – Chris Muschong, Kunz, Leigh and Associates, and Tammy Banks Claim Status Subworkgroup Co-Chairs
  • Understanding the Models, Transactions, and Data Flows of Encounter Data Reporting – WEDI Claims Subworkgroup Co-Chairs
  • Barriers to the Broader Adoption of Telehealth – WEDI Telehealth Workgroup Co-Chairs
  • Anatomy of Value-Based Payment: An Interactive Discussion – Adele Allison, DST, WEDI Payment Models Workgroup
  • Additional presenters scheduled to appear include John Baackes, CEO, LA Care; Dr. Joe Cunningham, Managing Director, Sante' Ventures; and Dr. Viet Nguyen, Technical Director, Da Vinci Project

The event will kick-off with pre-conference sessions hosted by WEDI’s workgroups who will hold working meetings that will provide an opportunity for workgroup members to meet face-to-face, collect input, exchange ideas and make recommendations for changes in the industry. Members and nonmembers will also have the opportunity to sit in and understand some of the WEDI projects of focus.

WEDI 2019 is open to all interested health care stakeholders across provider, payer, vendor and government entities. Both WEDI members and non-members can visit the WEDI 2019 Conference page to register online and for information on discounted registration and room rates.

About WEDI
WEDI is the leading authority on the use of health IT to improve health care information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s health care system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit and connect with us on Twitter and LinkedIn.

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