Standards to Smarter Decisions: HL7 FHIR, Da Vinci, and AI-Powered Prior Authorization with Clinician Oversight, sponsored by MCG Health

Prior authorization is transitioning from a manual and fragmented process to a coordinated and standards-driven exchange of decision-ready data. By agreeing to share the right information in HL7 FHIR-based formats aligned with the HL7 Da Vinci Project, CRD/DTR/PAS, payers and providers enable reviewers to make faster and more informed determinations.

This session will explore how superior data exchange using HL7 FHIR standards can enhance LLMs and agentic automation, gathering, structuring, and matching evidence to criteria without entirely replacing essential clinical judgment. We will share practical approaches to combining automation efficiency with transparent “glass-box” metrics, allowing stakeholders to see both the speed and soundness of each decision.

Attend this webinar to:

1. Identify how HL7 FHIR and HL7 Da Vinci standards enable decision-ready data exchange between payers and providers
2. Design automation that balances speed, accuracy, and transparency with reviewer oversight
3. Apply a “glass-box metrics” (in LLM AI era) approach to build trust and measure both efficiency and decision quality

Your Presenters:

Rajesh (Raj) Godavarthi

Associate Vice President of Technology and Interoperability

MCG Health

Seun Balogun

Manager IT and Client Delivery

enGen