Itiliti Health News

How Prior Authorization Can Help Reshape the Public Perception of Payers

How Prior Authorization Can Help Reshape the Public Perception of Payers Health insurers face a credibility crisis. Despite playing a critical role in the healthcare system, payers are often viewed as obstacles rather than advocates, blamed for denials, delays, and…

Why Waiting to Act on CMS-0057 Puts NCQA Accreditation at Risk

Why Waiting to Act on CMS-0057 Puts NCQA Accreditation at Risk By January 1, 2027, CMS is requiring health plans to support electronic prior authorization (ePA) through FHIR APIs. Right now, that may feel like a faraway deadline because it’s…

Digitizing Medical Policies: The Key to Scalable Prior Authorization Automation

Digitizing Medical Policies: The Key to Scalable Prior Authorization Automation Prior authorization (PA) is undergoing a long-overdue transformation. The days of faxes, long turnaround times, and frustrating appeals are numbered, thanks to regulatory pressure and a growing demand for real-time,…

A Guide for Payers Choosing a Prior Authorization Vendor

A Guide for Payers Choosing a Prior Authorization Vendor With CMS-0057 placing prior authorization (PA) in the national healthcare spotlight, payers are facing a pivotal moment. For years, PA has been a source of frustration and inefficiency for payers, providers,…