CMS Interoperability: Automating Prior Authorization

This video demonstrates how the Prior Authorization process can be automated using the WSO2 Accelerator for Healthcare, in alignment with the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F).

We walk through:

• The complete prior authorization workflow
• How WSO2 simplifies prior auth using the FHIR standard and the Ballerina programming language
• A live demo showcasing end-to-end automation:
• → prior authorization request
• → questionnaire response
• → real-time decision retrieval

By leveraging SMART on FHIR and FHIR APIs, this implementation boosts efficiency, reduces administrative burden, and enhances the overall patient care experience.

🔗 GitHub Repo: https://github.com/wso2/reference-implementation-cms0057f