PRIOR AUTHORIZATION, CONSENT, AND FHIR...OH MY!

A LOOK AT EDIFECS' CONSENT MANAGEMENT SOLUTION

The Interoperability and Prior Authorization mandate (CMS-0057-F) is driving increased data sharing between payers, providers, and members/patients. Health plans have to adapt to this increase in data volume.

If that's not enough, plans also have to navigate complex new API opt-in and opt-out requirements and various state-specific nuances. Put it all together, and the need for stronger end-to-end member consent management becomes clear.

In this webinar, Edifecs’ AVP of Product Management Sergiu Rata discusses how CMS-0057-F is potentially impacting your member consent operations, including:

• The rule’s payer-to-payer opt-in and provider access opt-out requirements
• New stipulations in certain states that require health plans to provide a way for members to restrict sharing of behavioral health and abortion data
• The increased flow of data between organizations

Edifecs’ Consent Management solution helps streamline member consent for three different use cases:

• Payer-to-payer exchange
• Provider access
• Consent for sharing plan information with authorized representatives

For more information on how Edifecs’ solutions can help you comply with CMS-0057-F requirements and improve your member consent operations, get in touch with our team today!