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Insights into Prior Authorization Automation: Bridging Payer and Provider Clinical and IT Needs

Aug 9, 2023
2:00 pm EDT
Presented by MCG
Register Now Registration takes place at a third-party website.

About This Webinar

The topic of prior authorization regulation and automation has become ubiquitous, with daily mentions and discussions. Notably, the CMS proposed rule (PARDD API and FHIR) and numerous state legislations or regulations have been introduced to tackle prior authorization challenges.

Through the initial implementations, MCG Health has gained valuable insights into the challenges related to the clinical and IT requirements of payers and providers to support prior authorization requirements (PARDD API). MCG recognizes the intricate interplay between clinical decision-making and technological infrastructure. MCG has also observed firsthand the complexities and intricacies of aligning clinical guidelines and protocols with the IT systems utilized by payers and providers for prior authorizations.

Join us for an informative webinar where MCG will offer valuable insights into prior authorization automation and show how they bridge the clinical and IT needs of payers and providers for successful implementation.

This Webinar Will

  • Summarize the CMS proposed prior authorization rule (PARDD API, CRD/DTR/PAS, FHIR, X12)
  • Illustrate prior authorization challenges faced by payers and providers, particularly in relation to their clinical and IT needs
  • Assess the importance of bridging clinical and IT requirements including, recognizing the significance of aligning clinical decision-making with IT infrastructure to streamline the prior authorization process
  • Discuss how MCG's solutions bridge this gap and improve overall efficiency


Rajesh “Raj” Godavarthi

Associate Vice President, Technology & Interoperability

MCG Health

Rajesh “Raj” Godavarthi has been with MCG since 2003 and he oversees a team that are building the key interoperability solutions that are outlined in MCG’s roadmap for the future. In addition, Mr. Godavarthi is MCG’s primary representative in the HL7 Da Vinci Project. MCG has been an Associate Member of this consortium since 2019, and Mr. Godavarthi has led our efforts to support industry…

Learn more about Rajesh “Raj” Godavarthi

Brandy O’Diam

Associate Director, Product Management

MCG Health

Brandy O’Diam has experience as a nursing professional and has worked in the healthcare sector for over 15 years. More specifically, she has developed extensive experience in the payer space and utilization management. Prior to joining MCG Health, she was Director of Clinical Operations Integration and Automation at CareSource, one of the nation's largest Medicaid managed care plans which is…

Learn more about Brandy O’Diam