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Prior Authorizations: Considerations & Thoughts for Real-Time Processing

Dec 7, 2023
2:00 pm EST
Presented by Tata Consultancy Services
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About This Webinar

The Centers for Medicare & Medicaid Services (CMS) defines Prior Authorization as a request for “provisional affirmation of coverage” submitted for review before the service is rendered and a claim presented for payment. Prior Authorizations have been the Achilles heel of the Claims ecosystem. Many payers have standalone systems which impact the delivery of services to members. The multiple touchpoints, documents, and participants that contribute to the decision-making can increase response times and add inefficiencies to the process.

During this webinar, we will explore some of the possibilities with how health insurance providers can continue to monitor and ensure care is given at the right time and in the right setting while at the same time eliminating the current burden of doing so on the provider and member.

Attendees Will Learn About

  • Current challenges with prior authorizations
  • Regulations and impacts to payers and providers
  • Recommendations for how to improve Prior Authorizations experiences for providers and members


Bob Bowman

Principal, Interoperability and Standards


Bob Bowman is the Principal, Interoperability and Standards, at CAQH CORE, a non-profit alliance of healthcare industry leaders whose mission is the creation and adoption of healthcare operating rules that support standards, accelerate interoperability, and align administrative and clinical activities among providers, health plans, and consumers. Bob oversees the CORE Rule development process;…

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Alison Schambach

Healthcare Director

Tata Consultancy Services

Alison is a Director of Healthcare with TCS and oversees the domain consultant needs for Healthcare Practice. She brings with her a very high level of functional expertise in healthcare operations and analytics. She has leveraged this expertise in leading of a wide range of engagements. Her background and understanding of the end-to-end business processes has also helped in developing industry…

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Althea Robinson

Healthcare Domain Consultant

Tata Consultancy Services

Althea is a domain consultant and leads several key initiatives for the Healthcare Practice. She possess more than 30 years in the Healthcare Industry with extensive experience in support of Client engagements especially in the areas of Systems, Operations, Products, Claims and Benefit Administration. Recognized for creating strong strategic and tactical plans that drives improvements in…

Learn more about Althea Robinson