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Getting the latest healthcare news for you
Getting the latest healthcare news for you
Prior authorization just got a tech upgrade. Epic has launched a real-time prior authorization check tool embedded directly in its EHR, letting clinicians instantly see if a treatment needs insurer approval — no phone calls or fax machines required. Four health systems are already live with the feature, five months ahead of a federal mandate requiring payers to support electronic prior auth APIs by January 1, 2027.
Prior authorization just got a tech upgrade. Epic has launched a real-time prior authorization check tool embedded directly in its electronic health record (EHR), letting clinicians instantly see whether a treatment requires insurer approval — no phone calls, faxes, or separate insurance portals needed. The tool uses an industry-standard API called Coverage Requirements Discovery (CRD), built on HL7 FHIR standards.
Four health systems — Ochsner Health, Froedtert ThedaCare Health, Denver Health, and Summit Health — are already live with the feature, working with insurers UnitedHealthcare, Aetna, and Network Health. Sixteen additional payers are currently in testing. Epic also has its eye on AI to further automate the prior auth workflow beyond just real-time checks.
By the Numbers:
Why it matters: Prior authorization has long been one of healthcare's biggest administrative headaches, delaying care and burying clinicians in paperwork. This launch signals a real shift toward automation — and puts the industry five months ahead of a key federal compliance deadline.
