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Where Do We Begin? Hear First-Hand Accounts of Payer-to-Payer Data Exchange and End-to-End Prior Authorization Implementations at Upcoming Community Roundtable

Written by Leslie Amorós | May 20, 2024 6:09:35 PM

May 29 Session features athenahealth, Availity and Humana and honors HL7 Da Vinci Project Community Champions from 4:00 - 5:30 pm ET

Join us this month to hear real-world HL7 FHIR and Da Vinci implementation stories that will provide you with inspiration and insight into how you can apply the learnings of athenahealth, Availity and Humana to your organization’s efforts to reduce friction, increase efficiency and meet the federal interoperability rules. 

After recognizing the 2023 HL7 Da Vinci Project Community Champions, representatives of Availity and Humana will provide a current snapshot of Da Vinci’s effort to create a nationwide interoperable approach among payers using the Payer Data Exchange (PDex) Implementation Guide, which enables payers to create a member’s health history using clinical resources which can be understood by providers and electronic medical records (EMR) systems. This discussion provides an opportunity to better understand dynamics you’ll encounter in achieving payer-to-payer exchange compliance such as consent and endpoint discovery.  Attendees will gain a foundational understanding of the new regulatory requirements, learn about technical and business challenges and benefits from real-world implementers and gain insight into how industry is working together. 

After the payer-to-payer data exchange discussion, athenahealth, Availity and Humana will share how they are using Da Vinci implementation guides for an end-to-end prior authorization collaboration. The goals of this collaboration were to improve transparency into the prior authorization process, reduce the administrative burdens for both the health plan and its provider network, leverage available clinical content, and accelerate the process through automation. This presentation provides the specifics regarding implementation; how the organizations approached technical, data- and standards-based challenges; reviews critical lessons learned from the initiative; and provides key benchmarks and metrics of post-go-live success. 

“Real-World Successes: HL7 Da Vinci Project Community Champions, Payer-to-Payer Data Exchange and End-to-End Prior Authorization” is scheduled for May 29, 4 - 5:30 p.m. ET and features the following presenters: 

  • Mark Fleming, Senior Director of Product, Availity    
  • Justin Howe, Senior Manager, Product, Availity  
  • Amy Mattingly, Director, UM Interoperability, Product Management at Humana 
  • Gillian McCabe, Director of Product, Authorization Management at athenahealth 
  • Gurbinder Singh, Principal Product Manager, Humana 
  • Anna Taylor, HL7 Da Vinci Project Steering Committee member and Associate Vice President, Value Based Care and Population Health Management, MultiCare Connected Care 

The session is moderated by Alix Goss, HL7 Da Vinci Project PMO, and Senior Consultant, Point-of-Care Partners.

Register Today for the May Community Roundtable!

To register and attend this free webinar, visit:  https://bit.ly/4bygS9g

About the Community Roundtable

The goal of the Da Vinci Project’s community roundtables is to increase public awareness among payers, providers and vendors of the resources and progress coming out of Da Vinci’s efforts. These 90-minute virtual sessions are open to Da Vinci members as well as the public and highlight how members leverage the Da Vinci use cases and implementation guides in action in workflow.

Typically, two or three organizations showcase their work and answer audience questions, allowing for a vibrant discussion and fostering industry understanding of the Da Vinci work products and resulting market solutions. Sessions are recorded and available online after the event.

Join the Community

To learn more and join the community, visit hl7.me/davincinews.