The digital, API-driven version of prior authorization that replaces manual fax- and phone-based submission with structured data exchange between providers and payers, typically built on FHIR standards.
What it means
ePA is the industry's response to decades of manual, inconsistent prior auth workflows. Instead of faxing forms and calling payers for status updates, ePA uses standardized APIs to submit requests, check requirements in real time, and receive determinations electronically. CMS-0057-F requires impacted payers to support FHIR-based ePA, aiming to shrink turnaround times and eliminate the guesswork of payer-specific portals. Ethermed's platform is built natively on this model rather than retrofitted onto legacy submission methods.
