Beyond 0057 Compliance: Translating Mandated APIs into Impact. Sponsored by InterSystems

Mandated APIs are only the starting point for transforming prior authorization. In this WEDI virtual spotlight, sponsored by InterSystems, industry innovators will explore how payers, providers, and technology partners can move beyond compliance to deliver measurable improvements in patient access, clinician workflow, and operational efficiency. We’ll begin with a mini session on digitizing medical policies, unpacking how structured, computable content can accelerate automation, improve transparency, and serve as the foundation for modern electronic prior authorization. The conversation will expand into a dynamic panel discussion on innovation in prior authorization, including:

• The role of healthy data in enabling scalable, accurate automation 
• AI-powered adjudication to streamline decision-making and reduce manual review 
• Replacing CQL with next-generation AI for faster, more adaptive rules processing 
• Standardizing Documentation Templates & Rules (DTR) for interoperability and reusability 
• Gold carding programs to reward high-quality providers and reduce unnecessary prior authorization requests 

Attendees will gain a clear picture of how AI, standards, and stakeholder collaboration can work together to transform mandated technology requirements into meaningful, lasting impact across the health sector.