Prior Authorization at a Crossroads: Meeting CMS-0057 While Reducing Operational Burden
Prior authorization remains one of the most resource-intensive and provider-friction–heavy processes for health plans, further complicated by growing regulatory requirements under CMS-0057. As timelines shorten and expectations for electronic, real-time decisions increase, plans must modernize utilization management without disrupting core operations.
In this webinar, ZeOmega will showcase its AI-driven Prior Authorization solution, designed to automate authorization intake, digitize medical policies and clinical guidelines into executable decision trees, and enable faster, more consistent UM decisions. Attendees will learn how ZeOmega applies AI across the authorization lifecycle, from intelligent document ingestion and AI-assisted clinical assessments to machine-learning–based optimization of authorization outcomes. The session will also highlight ZeOmega’s Smart Authorization Gateway, which supports CMS-0057 compliance and orchestrates electronic prior authorization submissions across provider networks. The solution is available both within the Jiva UM platform and as a standalone offering for non-ZeOmega customers.
Learning Objectives
- Learn how health plans can prepare for CMS-0057 requirements using an electronic, real-time prior authorization gateway
- Explore how medical policy and clinical guideline digitization can enable more consistent, explainable UM decisions at scale
- Understand how AI can be applied across the prior authorization lifecycle to reduce manual effort and improve decision turnaround times
Speakers
