Experienced technology leaders illuminate the appropriate use of artificial intelligence and automation in prior auth workflows

LAS VEGAS, June 4, 2024 /PRNewswire-PRWeb/ -- MCG Health, part of the Hearst Health network and an industry leader in technology-enabled, evidence-based guidance, announces its Associate VP of Technology and Interoperability, Rajesh "Raj" Godavarthi, and Senior Manager of Technical Product Management, Larry McEntire II, will be featured speakers at the upcoming America's Health Insurance Plans (AHIP) 2024 conference. This premier event for health plan professionals will take place from June 11-13, 2024, in Las Vegas, Nevada.

Mr. Godavarthi and Mr. McEntire are set to deliver a compelling Lunch & Learn session, " Insights into CMS' Prior Auth Rule: How to Leverage AI and Automation" on Tuesday, June 11, from 12:00 – 12:45 pm PT. Their presentation will delve into the complexities of the recent CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F), focusing on the integration of artificial intelligence (AI) and advanced data interoperability to optimize health insurance provider operations.

The session aims to provide attendees with a clear understanding of how to employ AI and interoperability strategies to successfully manage healthcare data more effectively, thus streamlining processes, reducing administrative burdens, and fostering a member-centric approach to healthcare.

Key objectives of the session will include:

• Identifying key opportunities for efficiency gains: Explore how combining AI with enhanced data interoperability can streamline processes across a member's healthcare journey
• Strategizing for successful implementation: Unpack the intricacies of utilization management's (UM) prior authorization workflows and discuss the necessary clinical and technological aspects to address potential challenges
• Communicating benefits to stakeholders: Present the tangible benefits of these advanced approaches, including improved member outcomes, cost reductions, and strengthened regulatory compliance

Mr. Godavarthi, a recognized HL7® Da Vinci Community Champion and ONC HITAC member, said, "The MCG team is looking forward to sharing valuable insights at AHIP 2024 on the CMS Final Rule and our experiences implementing these new prior auth workflows." He added, "MCG is also in a unique position to provide health plans with critical guidance on leveraging artificial intelligence appropriately for prior authorizations."

For more information about the session and to register for AHIP 2024, please visit https://www.ahip.org/conferences/ahip-2024.

About MCG Health
MCG, part of the Hearst Health network, provides unbiased clinical guidance that gives healthcare organizations confidence in delivering patient-centered care. MCG's artificial intelligence and technology, infused with clinical expertise, enable its clients to prioritize and simplify their work. MCG's world-class customer service ensures its clients maximize the benefits of licensing MCG solutions – demonstrating improved clinical and financial outcomes. For more information visit http://www.mcg.com.

About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person's health journey. Care guidance from Hearst Health reaches the majority of people in the U.S. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, and MHK (formerly MedHOK). Hearst also holds a minority interest in the precision medicine and oncology analytics company Aster Insights. Follow Hearst Health on X @HearstHealth and LinkedIn @Hearst-Health.

Media Contact

Arri Stewart, MCG Health, (206) 389-5405, arri.stewart@mcg.com, https://www.mcg.com/

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SOURCE MCG Health