FHIR-BASED ELECTRONIC PRIOR AUTHORIZATION

Transforming Prior Authorization for CMS compliance and enhance operational efficiency

Enable FHIR-based Prior Authorizations with CitiusTech's proven Interoperability and AI/ML services

FHIR-BASED ELECTRONIC PRIOR AUTHORIZATION

Need for compliance and beyond

Prior Authorization (PA) processes in healthcare have been recognized as critical yet cumbersome. The CMS interoperability necessity and PA Final Rule published in January 2024 mandate an FHIR-based electronic Prior Authorization (ePA) and a fixed turn-around time for PA decisions. We stand on the brink of a transformative era for the PA workflow witnessing the rise of streamlined processes and intelligent automation opportunities to realize operational efficiencies and ROI.

CitiusTech is helping Payers and Providers to navigate the CMS Prior Authorization rules with FHIR-powered ePA solutions, ensuring protection against potential penalties while reducing administrative costs and a focus on driving ROI beyond foundational FHIR API compliance.

PERSPECTIVE

Prior Authorization transformation with intelligent automations

FLYER

FHIR based Electronic Prior Authorization

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INFOGRAPHIC

CMS Final Rule to Streamline PA infographic

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CASE STUDY

ePA – Provider burden reduction using DaVinci project

Assessment of current Prior Auth process, gap analysis

Design and architecture recommendation, vendor selection

Regulatory reporting, operational audits

Implementation and configuration of Interoperability layer

Intelligent automation using S/W engineering, AI, and GenAI

Modernization (CQL enablement, Microservices etc.)

KEY BENIFITS

Driving business success Prior Auth solutions

Compliance simplified

Navigate CMS Prior Authorization rules with our FHIR-powered ePA solutions, ensuring accelerated compliance and protection against potential penalties.

Increased efficiency

Dramatically reduce administrative costs and boost your decision-making processes with GenAI capabilities, reducing turnaround time and unnecessary expenses.

Scalability and flexibility

Adapt to changing healthcare landscapes with scalable solutions, allowing for easy integration with your existing systems and expansion for future needs.

ACCELERATORS

Interop Frameworks

FHIR-based Prior Auth API

SMART on FHIR Apps

CQL-FHIR Mapping Libraries

INSIGHTS

Practical thought leadership on healthcare and technology

CMS Final Rule to Streamline PA infographic

Empowering Healthcare – The transformation of Prior Auth with intelligent automations

Ushering in a new era of efficiency for Healthcare Payers and Providers: Electronic Prior Authorization (ePA)

ePA - DaVinci Burden Reduction PA

CMS Final Rule to Streamline PA infographic

CMS Interop and PA Final Rule infographic

FHIR based Electronic Prior Authorization

FHIR-BASED ELECTRONIC PRIOR AUTHORIZATION

Transforming Prior Authorization for CMS compliance and enhance operational efficiency

FHIR-BASED ELECTRONIC PRIOR AUTHORIZATION

Need for compliance and beyond