Virtual Learning Center
Gain insights into prior authorization below
Recent Webinars
Did you miss one of our most recent webinars or videos? Click below to catch a replay:
Prior Authorization Policy Digitization, presented by Drummond & Itiliti Health
In this webinar recording, Itiliti Health discusses the challenges its customers face when testing policies across vendor systems. Drummond shows how its FHIRplace testing framework addresses those gaps. Together, they bring customer experience and testing expertise to the conversation.
The Next Phase of DTR: Policy Management and Delegated Vendor Orchestration
As DTR implementation moves forward, health plans are confronting challenges that go beyond digitizing policy and enabling the transaction itself: how to manage the medical policies and DTR questionnaires that inform prior authorization decisions, and how to orchestrate responses when responsibility is distributed across the health plan, delegated vendors and other third parties.
AI in Prior Auth: Efficiency, Guardrails, and What Bot Wars Mean for Payers
AI is reshaping how prior authorization decisions are made, but not always in ways payers can control. In this fireside chat, leaders from Itiliti Health and MRIoA explore where AI genuinely improves PA efficiency, where guardrails are non-negotiable, and what the rise of patient-side AI tools means for payer operations. This session features actionable framing for health plan leaders navigating the next phase of prior auth modernization.
Getting Medical Policy Digitization Right for AI-Driven Prior Authorization
The way medical policies are digitized can mean the difference between consistent, reliable automation and AI that misinterprets clinical intent. In this webinar, we take a deeper look at what effective medical policy digitization requires, including the implementation decisions that have the greatest impact on downstream AI performance and interoperability.
Prior Auth Compliance: 3 Payer Case Studies, 4 Key Implementation Decisions
Health plans have spent years preparing for CMS-0057. This webinar addresses something the planning documents don't cover: what implementation looks like and what separates organizations that simply achieve compliance from those that use CMS-0057 to transform prior authorization. Through three real-world health plan case studies, Michael Lunzer explores the four implementation decisions that have the greatest impact on long-term success.
AI and Prior Authorization: What Actually Works and What Doesn’t
For payers, prior authorization is often approached as a workflow or automation challenge, with many organizations turning to AI as the primary solution. This webinar will explore where AI adds value, where it falls short, and what capabilities are truly required to modernize prior auth for payers.
Integrated Interoperability Platform & Prior Authorization Solution for CMS-0057 Compliance
Watch this WEDI webinar replay where Keith Brick from Itiliti Health and Jeremy Yoon from 1upHealth walk through a real-world integration scenario, demonstrating how these critical components connect to enable CRD, DTR, and PAS transactions. You'll see how data flows between payers and providers through FHIR APIs, how that data informs providers on prior authorization criteria, and where policy data fits into the technical architecture.
Modernizing Medical Policy Management: From Digitization to Questionnaires
Catch the replay of our webinar on modernizing medical policy featuring a recap of what CMS 0057 requires of payers when it comes to policies, how payers can modernize ongoing medical policy management with seamless versioning and long-term process optimization in mind, a case study highlighting how we helped a large BUCA plan digitize their entire database of medical policies and more!
WEDI Summer Forum Playlist: Itiliti Health Session Replays
This is a playlist of four videos from Itiliti Health's presentations at the WEDI Summer Forum in 2025. Videos include: 1. Making Medical Policy Digitization and Management Easy 2. Prior Authorization Solution Design for a Major BUCA Plan 3. Digitizing Coverage: Making Sense of CMS-0057-F's Policy Transparency Mandate 4. Exploring Prior Authorization as a Business Process
Why Cox HealthPlans Chose Itiliti Health as Its Prior Authorization Vendor
In this video, Susan Sanchez, Chief Information Officer of Cox HealthPlans, shares why their organization chose Itiliti Health as their prior authorization vendor. Susan shares the reasons behind their decision, the critical factors that influenced the selection process, and how the solution is helping meet federal mandates while ensuring operational efficiency. Tune in to hear her insights and takeaways that could help other health plans navigate similar hurdles.
WEDI Spotlight on State Medicaid for CMS 0057: Key Technical Provisions
Itiliti Health provides a comprehensive technical walkthrough of the CMS-0057-F final rule and its implications for state Medicaid agencies. This session, part of WEDI's webinar series on prior authorization and interoperability improvements required by the new rule, breaks down key technical provisions to help state Medicaid leaders understand implementation requirements, plan strategically, and address operational challenges as they prepare for compliance. You can also watch the full WEDI presentation here.
Integrating ePrior Auth with External Care Guideline Vendors, UM, CM & Claims Systems (Part 2 of 2)
As CMS-0057 drives payers toward end-to-end prior auth automation, seamless integration across core systems is no longer optional—it's essential. In this session, we explore how prior authorization solutions connect with external care guideline vendors and internal systems like utilization management (UM), case management (CM), and claims platforms to enable compliance, streamline workflows, and prepare for a future state of touchless prior authorization.
CMS-0057: Streamlining Prior Authorization and Delegated Vendor Collaboration (Part 1 of 2)
Join us in a WEDI event replay for a deep dive into how automated solutions are reshaping the future of prior authorization. This session explores how prior auth vendors can seamlessly integrate with delegated vendors to help payers meet CMS-0057 mandates, streamline administrative workflows, and accelerate the transition toward a touchless prior authorization environment.
How an Interoperability Server and Prior Auth Solution Work Together for CMS-0057 Compliance
Catch the replay of our live demo with Onyx Technologies, hosted in partnership with WEDI! Key highlights from the demo: ➡️ Walkthrough of the integrated Itiliti Health and Onyx solution, including CRD, DTR, and PAS capabilities ➡️ Tips for health plans on implementing these new standards and overcoming common adoption barriers