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Two opposing abstract data networks exchanging light beams across a dark table, symbolizing automated negotiation between payer and provider AI systems

The Claim Is Now Negotiated by Two Machines

As CMS-0057-F pushes payers toward automated prior authorization and providers deploy AI to fight denials, no rule governs the models arguing with each other.

Two intersecting beams of light forming a checkpoint over a stream of abstract data, representing AI-driven prior authorization under new oversight requirements.

Prior Authorization AI Now Has Two Deadlines and One Build

Health plans face a January 2027 FHIR API mandate and new congressional scrutiny of AI-driven utilization management at the same time, on the same systems.