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Follow on Google News | ![]() AssureCare Launches Seamless Integration to Submit Prior Authorization Requests from EHRsAssureCare's MedCompass Platform Achieves Compliance with CMS Interoperability and Prior Authorization Final Rule, saving providers valuable time and resources
By: AssureCare, LLC The CMS final rule mandates that impacted payors, including Medicare Advantage Organizations, state Medicaid and Children's Health Insurance Program (CHIP) Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plans (QHP) issuers on Federally Facilitated Exchanges (FFEs), must implement and maintain certain Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) APIs by January 2027. Among these requirements, the Prior Authorization API is a crucial component designed to improve the electronic exchange of healthcare data and streamline the prior authorization process. AssureCare's MedCompass, a CMS-certified platform, can seamlessly receive prior authorization requests via the FHIR-based API. This functionality not only aligns with the new CMS regulations but also empowers payors to significantly reduce turnaround times and minimize the administrative burdens traditionally associated with prior authorization. "This rule introduces substantial challenges for payors, as the Prior-Authorization Decision Timeframes for expedited and standard requests have been drastically reduced. The Turnaround Time (TAT) has been halved for standard requests from 14 days to just 7 days. This demands that payors either double their operational capacity or adopt advanced technology to accommodate these changes without inflating their cost structure. Recognizing the significant impact this could have on our clients and the industry at large, we proactively invested in making our system compliant ahead of schedule to ensure a smooth transition and help payors mitigate potential cost increases," said Dr. Yousuf Ahmad, President and CEO of AssureCare. About AssureCare® AssureCare provides cutting-edge population health management software for healthcare and human services organizations like payors, providers, and pharmacies. For media inquiries, please contact LBurke@assurecare.com End
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