Posts by Samantha Holvey
Video: Adopting a FHIR-based approach to Prior Authorization, Presented by InterSystems
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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 problem. Although X12…
Read MorePodcast Episode 117: Breaking Down the Silos on the Way to Achieving Interoperability – A Conversation w/ Darena Solutions CEO Pawan Jindal, MD
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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 patients. They discuss how technology, the 21st Century Cures Act, and patient literacy aided in…
Read MoreVideo: 275 (and 277 RFAI) Early Adopters
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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…
Read MoreCongress Proposes Relief on Prior Authorization, but CMS is Ahead of the Game
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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 Use of Prior Authorization Under…
Read MoreAugust Emerging Tech Meeting with Mike Rapach, President & CEO of CareFirst Health Plan Maryland
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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, Mike has taken a unique path towards…
Read MorePodcast Episode 116: Guiding a Path for Patient Centric Health Care, A Conversation with Path’s Kermit Farmer
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F August 18, 2023 Michael speaks with Kermit Farmer, founder and Chief Ethos Officer of Paths, a service that gives doctors and team members the ability to create and share educational material to help their patients in the journey from diagnosis through recovery. Learn more at…
Read MoreSolving for Automated Prior Authorization: Three Things You Need to Know
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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, provider burnout, care…
Read MorePodcast Episode 115: Data – The Key to Addressing Health Disparities
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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 are doing to…
Read MoreOpportunities and Challenges: Moving from ICD-10 to ICD-11
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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…
Read MoreThe Weekly – August 2023
Knowledge Center Episode 232- The Role of Intermediaries in CMS-0057F 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 &…
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