Navigate Challenges of the Interoperability and Prior Authorization (CMS-0057) Rule to Gain Strategic Benefits.

Are You Ready? 

Compliance with CMS-0057 presents a series of challenges that payers must navigate to not only meet the regulatory deadlines but also to leverage these changes for strategic advantage. Here’s how you can turn potential obstacles into opportunities for growth and efficiency.Path to Compliance_Payer CMS-0057 Graphic

Key Challenges for Payers:

Updating Your Interoperability Roadmap:

  • Challenge: Align your existing systems and processes with new CMS-0057 requirements.

  • Opportunity: Streamline operations and improve data-sharing capabilities.

  • POCP Solution: We help you assess your current state, identify gaps, and develop a detailed compliance timeline that aligns with your strategic goals.

Planning for Change Management:

  • Challenge: Engaging stakeholders and managing organizational change effectively.

  • Opportunity: Enhance team collaboration and ensure seamless implementation of new processes.

  • POCP Solution: We develop and execute comprehensive education programs for providers and members and create a robust framework for internal change management and ongoing process improvements.

Prioritizing and Establishing Order of Operations:

  • Challenge: Coordinating multiple compliance activities and managing vendor relationships.

  • Opportunity: Optimize your processes for better efficiency and cost management.

  • POCP Solution: Our team conducts comprehensive data and system gap analyses, helps you understand vendor capabilities, and assists in selecting the right partners to meet your needs.

Achieving Timely Compliance:

  • Challenge: Meeting the strict deadlines set by CMS-0057.

  • Opportunity: Establish your organization as a leader in compliance and interoperability and avoid being the target of enforcement actions.

  • POCP Solution: Our phased approach ensures timely decision-making, execution, and transition. We assist you in vendor selection, budgeting, contracting, and provide continued support, guidance, and mentoring throughout the compliance journey.

How POCP Can Help You:

Point-of-Care Partners is your trusted advisor for navigating the complexities of CMS-0057. Let's work together to turn compliance challenges into strategic advantages. We offer: 

  • Expertise: With over 20 years in Health IT and a proven track record, POCP brings unparalleled experience to help you navigate CMS-0057 requirements.
  • Neutral, Unbiased Partnership: As objective advisors, we prioritize your success and offer rigorous, systematic evaluations of your current processes and technologies.
  • Deep Industry Knowledge: Our team includes leaders with decades of experience in interoperability and prior authorization, active in standards organizations like NCPDP, HL7, and FHIR Accelerators.

Contact Us Today to Assess & Plan Your CMS-0057 Compliance Journey
Interoperability Enterprise Graphic
Interoperability is about more than just a technology investment. Especially with the CMS-0057 requirements, there are enterprise-wide impacts. Is your organization prepared to undertake the education and process changes across departments to be effective?
CMS-0057 API Requirements Table
This table outlines which standards and implementation guides may be leveraged or are required to be used by the CMS-0057 Rule