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The process of securing prior authorization (PA) for medical procedures and tests is costy and burdensome for provider organizations, taking away time that could otherwise be spent supporting patients directly. Staff must keep up with varied and changing payer requirements and use a wide variety of portals as well as phone and fax for submitting PA requests and tracking their progress. eviCore’s intelliPath solution simplifies and automates the entire prior authorization workflow for any payer and any procedure. A single, unified queue makes it easy for users to submit and track cases, and fulfill requests for additional clinical information as needed to secure a decision.
Because the product is integrated with athena, prior authorizations cases are automatically populated with the right patient and provider information, and implementation is easy. Provider organizations that deploy intelliPath will benefit from a dramatic reduction in operating costs (up to 50%) from elimination of administrative complexity. And because intelliPath ensures that case information is complete and correct early on in the process, it reduces delays and denials.
intelliPath manages the prior auth process--from submission to decision--by executing the following functions: - Verify: Verifies patient elibility and whether a PA is required - Submit: Auto-populates the PA case and submits - Clinical Review: Expedites the collection of clinical data where required - Track: Dynamically updates case progress and approved/pended status - Communicate: Manages all provider/payer communications
eviCore’s solution is unique in the industry. As the nation’s largest benefit manager, processing over 85,000 prior authorization requests per day on behalf of over 120 payers, our decisions impact 40% of the medical spend. When using intelliPath to submit PA requests to eviCore, providers will experience even faster turnaround times through our AI-driven automation.
eviCore is committed to removing barriers to cost-effective, appropriate care by streamlining the medical prior authorization process. IntelliPath, integrated with Athena, is the fastest path for authorizations.