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Building the Right Foundation for AI in Prior Authorization, presented by Itiliti Health

June 18, 2026 1:00 PM - 2:00 PM (EDT)

Description

AI has the potential to transform prior authorization, but its effectiveness depends on the quality and fidelity of the underlying policy data. Many organizations are already digitizing medical policies to support CMS-0057 and broader automation initiatives, but not all approaches preserve the clinical intent needed for AI-driven prior authorization. This session explores how policy digitization directly impacts AI performance in prior authorization, including why some approaches introduce variability, misinterpretation risk, and inconsistent policy execution across workflows. We’ll discuss what “policy fidelity” means in practice, how to convert medical policies into structured, computable data that AI can use reliably, and why preserving clinical nuance is essential for scalable, trustworthy automation. Attendees will also learn how a clinically governed approach to policy digitization creates a stronger foundation for AI, real-time interoperability, and long-term prior authorization modernization. The session will include practical lessons learned from organizations implementing these strategies today under CMS-0057. Your Presenters: Michael Lunzer, Founder & CEO, Itiliti Health Chad Frank, CPO & COO, Itiliti Health

Time

Eastern Time

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Contact Information

WEDI
Name: Michael McNutt
Email: mmcnutt@wedi.org
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