Prior authorization remains one of the most labor-intensive and time-consuming processes in healthcare, often relying on manual faxes and phone calls. At the same time, new regulatory mandates such as CMS-0057 are pushing organizations to implement greater transparency and API-enabled workflows.

kAm+6~>682VD $>2CE pFE9 ~AE:>:K6C k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^;CF9Qm2AA=:6D px 2?5 H@C<7=@H 2FE@>2E:@?k^2m E@ DFAA@CE C62=\E:>6 52E2 6I492?86 36EH66? A2J6CD 2?5 AC@G:56CD[ 96=A:?8 @C82?:K2E:@?D >66E 6G@=G:?8 C6BF:C6>6?ED H9:=6 C65F4:?8 >2?F2= 25>:?:DEC2E:G6 3FC56?D 2?5 DEC62>=:?:?8 E96 42C6 2AAC@G2= AC@46DD]k^Am

kAmQpD A2J6CD 2?5 AC@G:56CD 7246 >@F?E:?8 7:?2?4:2= 2?5 C68F=2E@CJ AC6DDFC6D[ :?677:4:6?4:6D 😕 AC:@C 2FE9@C:K2E:@? H@C<7=@HD 2>A=:7J E96 DEC2:?[Q D2:5 $F92D #2>2492?5C2[ ‘![ !C@5F4E $EC2E68J 2?5 x??@G2E:@?[ +6~>682] Q(6 36=:6G6 +6~>682VD C64@8?:E:@? 😕 E9:D v2CE?6C |2C<6E vF:56 C67=64ED @FC 4@?E:?F65 4@>>:E>6?E E@ 96=A:?8 962=E942C6 @C82?:K2E:@?D DEC62>=:?6 AC:@C 2FE9@C:K2E:@? AC@46DD6D[ :>AC@G6 677:4:6?4J 2?5 F=E:>2E6=J DFAA@CE 72DE6C 2446DD E@ 42C6]Qk^Am

kAm+6~>682 H2D 2=D@ C64@8?:K65 😕 E96 k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^;CF:Qma_ad v2CE?6C|2C<6E vF:56 7@C &]$] w62=E942C6 !2J6C r2C6 |2?286>6?E (@C<7=@H pAA=:42E:@?Dk^2m] xE 92D 2=D@ 366? A@D:E:@?65 2D 2 =6256C 😕 k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^;CF;QmtG6C6DE vC@FAVD a_ad !tpz® |2EC:I pDD6DD>6?Ek^2m 7@C E96 D64@?5 4@?D64FE:G6 J62C]k^Am

kAmv2CE?6C[ |2C<6E vF:56 7@C x?E6==:86?E !C:@C pFE9@C:K2E:@?[ &]$] w62=E942C6 ~C82?:K2E:@?D[ k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^;CF2?52 s2==V~449:@k^2m[ k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^9_75Qmr@??:6 $2=8Jk^2m[ `a u63CF2CJ a_ae]k^Am

kAmvp#%}t# 😀 2 C68:DE6C65 EC256>2C< 2?5 D6CG:46 >2C< @7 v2CE?6C[ x?4] 2?5^@C :ED 277:=:2E6D 😕 E96 &]$] 2?5 :?E6C?2E:@?2==J 2?5 😀 FD65 96C6:? H:E9 A6C>:DD:@?] p== C:89ED C6D6CG65]k^Am

kAmv2CE?6C 5@6D ?@E 6?5@CD6 2?J G6?5@C[ AC@5F4E @C D6CG:46 56A:4E65 😕 :ED C6D62C49 AF3=:42E:@?D[ 2?5 5@6D ?@E 25G:D6 E649?@=@8J FD6CD E@ D6=64E @?=J E9@D6 G6?5@CD H:E9 E96 9:896DE C2E:?8D @C @E96C 56D:8?2E:@?] v2CE?6C C6D62C49 AF3=:42E:@?D 4@?D:DE @7 E96 @A:?:@?D @7 v2CE?6CVD C6D62C49 @C82?:K2E:@? 2?5 D9@F=5 ?@E 36 4@?DECF65 2D DE2E6>6?ED @7 724E] v2CE?6C 5:D4=2:>D 2== H2CC2?E:6D[ 6IAC6DD65 @C :>A=:65[ H:E9 C6DA64E E@ E9:D C6D62C49[ :?4=F5:?8 2?J H2CC2?E:6D @7 >6C492?E23:=:EJ @C 7:E?6DD 7@C 2 A2CE:4F=2C AFCA@D6]k^Am

kAmp3@FE +6~>682k^Am

kAm+6~>682 6>A@H6CD 962=E9 A=2?D 2?5 @E96C C:D<\362C:?8 @C82?:K2E:@?D H:E9 E96 :?5FDECJVD =625:?8 E649?@=@8J 7@C D:>A=:7J:?8 A@AF=2E:@? 962=E9 >2?286>6?E] r=:6?ED FD:?8 +6~>682VD y:G2 w62=E942C6 t?E6CAC:D6 |2?286>6?E !=2E7@C> 6IA6C:6?46 DFA6C:@C H@C<7=@H 2?5 AC@G6? C6DF=ED 5F6 E@ 6I46AE:@?2= :?E68C2E:@? 42A23:=:E:6D[ F?>2E4965 4=:?:42= 4@?E6?E[ 2?5 2 A@H6C7F= CF=6D 6?8:?6] (:E9 566A 5@>2:? 6IA6CE:D6 2?5 2 4@>AC696?D:G6 F?56CDE2?5:?8 @7 A@AF=2E:@? 962=E9 492==6?86D[ +6~>682 D6CG6D 2D 2 ECF6 A2CE?6C 7@C 4=:6?ED H:E9 A6CD@?2=:K65 56A=@J>6?E 2?5 56=:G6CJ >@56=D] qJ 4@?D:DE6?E=J 6I4665:?8 4FDE@>6C 6IA64E2E:@?D 2?5 AC@;64E 36?49>2C682 92D 62C?65 2 C6AFE2E:@? 7@C 36:?8 AC@24E:G6[ C6=:23=6[ 2?5 565:42E65 E@ :>AC@G:?8 E96 962=E9 @7 :ED 4=:6?EDV >6>36CD] +6~>682 H2D ?2>65 k2 C6=lQ?@7@==@HQ 9C67lQ9EEADi^^AC]C6A@CE^9_76Qmq6DE 😕 z{p$ 7@Ck^2m !2J6C r2C6 |2?286>6?E $@=FE:@?D 😕 a_aa[ a_ab[ a_ac[ 2?5 a_ad] u@F?565 😕 a__`[ +6~>682 😀 AC:G2E6=J 96=5 2?5 9625BF2CE6C65 😕 !=2?@[ %6I2D]k^Am

kAm+6~>682 2?5 y:G2 2C6 C68:DE6C65 EC256>2C2C682[ x?4] @C :ED DF3D:5:2C:6D 😕 E96 &?:E65 $E2E6D 2?5 @E96C 4@F?EC:6D] ~E96C >2C2J 36 4=2:>65 2D E96 AC@A6CEJ @7 @E96CD]k^Am

kAm|65:2 r@?E24Eik^Am

kAmz2C:?2 $E23:=6k^Am

kAmpC:2 |2C<6E:?8 7@C +6~>682k^Am

kAmk2 C6=lQ?@7@==@HQ 9C67lQ>2:=E@iz$E23:=6o2C:2>2C<6E:?8]4@>Qmz$E23:=6o2C:2>2C<6E:?8]4@>k^2mk^Am

kAm$~rti +6~>682k^Am

kAm’:6H E96 @C:8:?2=k^Am

k2 9C67lQ9EEADi^^HHH]2446DD?6HDH:C6]4@>^?6HDC@@>^6?^962=E942C6\2?5\A92C>246FE:42=^K6@>682\C64@8?:K65\:?\E96\a_ae\82CE?6CC\>2C<6E\8F:56\7@C\:?E6==:86?E\“cgdbfQmAC6DD C6=62D6k^2m

kAm@? prrt$$ }6HDH:C6k^Am

Copyright 2026 ACCESS Newswire. All Rights Reserved.