Navigating Regulatory Changes in US Healthcare? Evaluate Your Tech Stack

The healthcare industry in the United States is no stranger to regulatory changes. As we reach the mid-point of 2024 and look towards 2025, it’s not a secret that the healthcare landscape is set to undergo significant transformations – both from a regulatory and legislative perspective.With the buzz of artificial intelligence (AI) and tools like generative AI, along with the historical promises of machine learning, and advanced analytics, the technology needed to ensure continuity of care – and continuity of experiences – already exists for both healthcare payers and providers. However, in many cases, the technology either hasn’t been implemented or hasn’t been used to its maximum potential.

Medigy Insights

Prior authorization is often a complex and time-consuming process for both payers and providers. However, advanced analytics can streamline this process by digitizing workflows and enabling electronic submission and approval of prior authorization requests. Advanced software tools can integrate with electronic health records to automate the verification of medical necessity criteria, reducing manual errors and improving efficiency. This ensures that patients receive timely access to necessary treatments, while payers can maintain appropriate utilization control, oversight, and documentation.

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