LIVE @ 1pm ET
Friday, August 28, 2026Â
Prior Authorization Is Becoming Visible.
But Is It Actually Getting Better?
CMS is requiring more prior-authorization transparency. New electronic workflows are coming. Industry leaders are promising faster decisions. The real question is whether any of it will reduce the burden hospitals experience every day.
The headline sounds promising. The data may tell a more complicated story.
For the first time, affected payers must publicly report important prior-authorization metrics. That should make payer performance easier to see—but visibility is not the same as accountability, and transparency is not automatically relief.
Approval percentages, denial percentages, appeal outcomes and turnaround-time averages can help. But the numbers can also conceal late decisions, extended reviews, repeated provider contacts, missing-information loops and service categories where performance is substantially worse than the overall average.
During this Finally Friday! LIVE discussion, we will examine what the new CMS reporting framework requires, what the recommended CMS template adds, what payers may still leave out and what hospital teams should verify before accepting a reassuring percentage at face value.
What we’ll put under the microscope
- Which prior-authorization metrics payers must now publish—and where the public should be able to find them.
- Why “posted” does not necessarily mean understandable, comparable or operationally useful.
- What approval, denial and approval-after-appeal percentages really measure.
- How mean and median turnaround times can hide the long tail of seriously delayed cases.
- Why several of the most revealing fields in the CMS template are labeled optional.
- What extension outcomes can reveal about payer behavior and patient delay.
- Which hospital-defined measures—including provider touches, resubmissions and order-to-service time—may tell the more useful story.
- What new electronic and EHR-based prior-authorization workflows may improve—and what they cannot fix without governance.
- How to separate current requirements, 2027 technology changes, proposed policies and voluntary industry commitments.
The questions hospital leaders should be asking
Is the payer’s report truly public?
Can a patient, provider or hospital employee reach it through ordinary navigation—without signing into a portal or already knowing the exact URL?
Do the numbers reconcile?
Are the numerator, denominator, reporting period, product and line of business clear enough to support a meaningful comparison?
What is missing?
Does the report show whether decisions were made within the deadline, what happened after an extension and how appeals changed the outcome?
Does your experience match the report?
Do your own timestamps, cases, service categories and provider-contact counts support the payer’s public performance story?
Optional for public reporting does not mean optional for internal measurement—or unimportant to the patient waiting for care.
What you’ll take back to your organization
- A clearer way to read and challenge payer prior-authorization reports.
- A practical list of missing or optional measures worth tracking internally.
- Questions to bring to payer meetings, contracting discussions and operational reviews.
- A 90-day starting point for identifying reports, reconciling cases and assigning ownership.
- One specific metric or timestamp your team can verify immediately.
Who should attend?
This discussion will be especially valuable for professionals working in:
- Utilization management and utilization review
- Case management
- Physician advisory services
- Patient access and scheduling
- Denials and appeals management
- Revenue integrity and revenue cycle
- Payer contracting and managed care
- Compliance, audit and clinical informatics
Bring your experience—and your skepticism
Finally Friday! LIVE is a peer discussion, not a one-way lecture. We’ll use audience polls, practical examples and panel questions to compare what the published numbers say with what hospital teams are experiencing in actual cases.
Bring a payer report, a difficult case, a missing timestamp or a metric you wish you had. The goal is not simply to admire new transparency. The goal is to decide what evidence would prove that prior-authorization burden is actually declining.
Join the discussion live—or register to watch on demand.
Friday, August 28, 2026 at 1:00 p.m. Eastern
Reserve Your Free Seat
One registration gives you access whether you join us live or watch later.
This program is intended for professional education and peer discussion. It does not constitute legal advice, establish a CMS-approved organizational workflow or guarantee a particular payment or appeal outcome.
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