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Integrations

Every payer channel, in one place.

Klivira covers 33 service lines today, across 8 workflow groups. Each service line lists the live payer portals we automate and the paper-only payers we handle via tracked fax.

Pharmacy & Specialty Drugs

PBM ePA, specialty enrollment, and benefits investigation across every major pharmacy channel.

Retail Medications

Pharmacy

Pharmacy-benefit prior auths across PBMs and direct payer ePA.

Portals
  • CoverMyMeds
  • Surescripts
  • Rx Benefits
  • OptumRx PreCheckUHC pharmacy
  • Express Scripts ePAESI / Cigna PBM
  • CVS Caremark / NovoLogixMedical-benefit drugs
  • Prime TherapeuticsBCBS PBM
Paper / fax fallback
  • VAFormulary paper form

Specialty Pharmacy

Pharmacy

Specialty drug enrollment, benefits investigation, and ordering.

Portals
  • AccredoSpecialty pharmacy
  • CVS SpecialtyLimited-distribution drugs
  • Optum SpecialtyUHC specialty
  • BriovaRx / Optum Rx Specialty

Endocrinology

Endocrinology

GLP-1s, growth hormone, CGMs, and insulin pumps.

Portals
  • CoverMyMeds
  • Rx Benefits
  • AccredoSpecialty pharmacy
  • AvailityAetna, Humana, UHC, UMR, BCBS

Infusion & Injectables

Medical-benefit infusions, J-codes, and buy-and-bill coordination — including Botox and Dysport.

Infusion & Buy-and-Bill

Infusion

Medical-benefit infusions, J-codes, and white-bag/clear-bag coordination.

Portals
  • CVS Caremark / NovoLogixMedical-benefit drugs
  • Magellan Rx MedicalMedical pharmacy PA
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • BotoxONE (buy & bill)
  • Dysport Direct

Botox

Neurology / Dermatology

Authorization plus buy-and-bill or specialty pharmacy ordering.

Portals
  • CoverMyMeds
  • Tricare
  • BotoxONE (buy & bill)
  • AccredoSpecialty pharmacy
Paper / fax fallback
  • BCBS, Cigna, VA, Carolina CompletePaper forms

Dysport

Neurology / Dermatology

Authorization and direct ordering for Dysport injectables.

Portals
  • CoverMyMeds
  • Tricare
  • Dysport Direct
Paper / fax fallback
  • BCBS, Cigna, VA, Carolina CompletePaper forms

Behavioral Health

TMS, Spravato/Esketamine, and outpatient psychiatry authorizations across commercial and Medicare.

TMS

Behavioral Health

Transcranial magnetic stimulation authorizations across major payers.

Portals
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare
  • eviCoreAetna, Cigna, BCBS plans
Paper / fax fallback
  • BCBSPaper form
  • TricarePaper form
  • Traditional MedicareNo prior auth required
  • Other MedicareCall number on back of card

Spravato / Esketamine

Behavioral Health

REMS enrollment and PA across commercial and Medicare plans.

Portals
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare
  • eviCoreAetna, Cigna, BCBS plans
Paper / fax fallback
  • TricarePaper form
  • Other MedicareCall number on back of card
  • Traditional MedicareNo prior auth required

Psychiatry & Behavioral

Behavioral Health

Outpatient therapy, IOP/PHP, residential, and behavioral medication PAs.

Portals
  • Optum Behavioral / Provider Express
  • Carelon Behavioral Health
  • Magellan Behavioral
  • AvailityAetna, Humana, UHC, UMR, BCBS

Imaging & Diagnostics

Advanced imaging, genetic and molecular testing, and cardiology imaging authorizations.

Advanced Imaging

Radiology

MRI, CT, PET, nuclear cardiology authorizations for most national payers.

Portals
  • RadMDNational imaging — most insurances
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • NIA / MagellanImaging, cardiology, PT/OT
  • AvailityAetna, Humana, UHC, UMR, BCBS

Genetic & Molecular Testing

Oncology / Genetics

Hereditary cancer panels, tumor profiling, and pharmacogenomics.

Portals
  • Avalon HealthcareBCBS lab benefits
  • Concert Genetics
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem

Cardiology

Cardiology

Echo, stress tests, cath, EP studies, and implantable device authorizations.

Portals
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • NIA / MagellanImaging, cardiology, PT/OT
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare

Oncology

Chemotherapy, immunotherapy, radiation oncology, and oncology pathway prior authorizations.

Radiation Oncology

Oncology

IMRT, proton therapy, SBRT, and brachytherapy authorizations.

Portals
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • AvailityAetna, Humana, UHC, UMR, BCBS

Medical Oncology

Oncology

Chemotherapy, immunotherapy, and oncology pathway authorizations.

Portals
  • OncoHealth / EvitiOncology pathway PA
  • New Century Health
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • CoverMyMeds

Surgical & Procedural

Inpatient and outpatient procedures across BCBS, UHC, Aetna, Humana, Tricare, and VA.

Orthopedics & MSK

Orthopedics

Joint replacements, spine surgery, injections, and DME bracing.

Portals
  • Cohere HealthHumana commercial & Medicare
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • AvailityAetna, Humana, UHC, UMR, BCBS

Gastroenterology

GI

Endoscopy, biologics for IBD, and capsule studies.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • eviCoreAetna, Cigna, BCBS plans
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare

Ophthalmology & Retina

Ophthalmology

Anti-VEGF (Eylea, Lucentis, Vabysmo), cataract, and retinal procedures.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • eviCoreAetna, Cigna, BCBS plans

ENT & Allergy

ENT

Sinus surgery, balloon sinuplasty, biologics for asthma, allergy immunotherapy.

Portals
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem

Urology

Urology

BPH procedures, oncology meds, and continence devices.

Portals
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • eviCoreAetna, Cigna, BCBS plans
  • Cohere HealthHumana commercial & Medicare

OB-GYN & Fertility

Women's Health

IVF, fertility meds, and surgical OB-GYN authorizations.

Portals
  • ProgynyFertility benefits
  • WINFertility
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare

Pain Management

Pain

Injections, RFA, spinal cord stimulators, and intrathecal pumps.

Portals
  • eviCoreAetna, Cigna, BCBS plans
  • Cohere HealthHumana commercial & Medicare
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • AvailityAetna, Humana, UHC, UMR, BCBS

Surgical Procedures

Surgery

General, bariatric, and elective surgery authorizations across BCBS, UHC, Aetna, Humana, Tricare, VA.

Portals
  • Blue e
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • Carolina Complete
  • Cohere HealthHumana commercial & Medicare
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Tricare
  • eviCoreAetna, Cigna, BCBS plans
  • One Healthcare IDUHC and UMR
Paper / fax fallback
  • VARFS paper form

Outpatient Specialty

Biologics and procedure-level PAs across the medical specialties driving the highest auth volume.

Neurology

Neurology

EEG, EMG, MS infusions, migraine therapies, and neurostimulators.

Portals
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • eviCoreAetna, Cigna, BCBS plans
  • Carelon Medical BenefitsBCBS, Healthy Blue, Anthem
  • AccredoSpecialty pharmacy

Dermatology

Dermatology

Biologics, Mohs, phototherapy, and cosmetic-medical crossover PAs.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • eviCoreAetna, Cigna, BCBS plans

Rheumatology & Immunology

Rheumatology

Biologics, IVIG, and infusion authorizations.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • CVS Caremark / NovoLogixMedical-benefit drugs
  • AvailityAetna, Humana, UHC, UMR, BCBS

Pulmonology & Sleep

Pulmonology

Sleep studies, CPAP/BiPAP, and pulmonary biologics.

Portals
  • AIM Sleep / CarelonSleep management
  • eviCoreAetna, Cigna, BCBS plans
  • CoverMyMeds
  • AvailityAetna, Humana, UHC, UMR, BCBS

Nephrology & Dialysis

Nephrology

ESA agents, dialysis access, and transplant workups.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • AvailityAetna, Humana, UHC, UMR, BCBS

Pediatrics

Pediatrics

Synagis, ABA therapy, growth hormone, and pediatric specialty referrals.

Portals
  • CoverMyMeds
  • AccredoSpecialty pharmacy
  • AvailityAetna, Humana, UHC, UMR, BCBS

Therapy, DME & Post-Acute

Physical/occupational therapy, chiropractic, durable medical equipment, home health, and multi-payer portals.

Physical, Occupational & Speech Therapy

Rehabilitation

Visit-limit authorizations and progress note submission.

Portals
  • WholeHealth Networks (Tivity)
  • American Specialty Health (ASH)
  • eviCoreAetna, Cigna, BCBS plans
  • NIA / MagellanImaging, cardiology, PT/OT
  • AvailityAetna, Humana, UHC, UMR, BCBS

Chiropractic & Acupuncture

Rehabilitation

Visit authorizations and SOAP note submission.

Portals
  • American Specialty Health (ASH)
  • Optum Physical Health

DME & Prosthetics

DME

Wheelchairs, braces, CGMs, pumps, and complex rehab equipment.

Portals
  • CGS DME MAC
  • Noridian DME MAC
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • CoverMyMeds

Home Health & Hospice

Post-Acute

Home health, infusion at home, hospice, and skilled nursing PAs.

Portals
  • myNEXUS (Anthem)
  • CareCentrix
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • Cohere HealthHumana commercial & Medicare

Multi-payer Portals

Cross-payer

Aggregator portals used across many specialties and lines of business.

Portals
  • AvailityAetna, Humana, UHC, UMR, BCBS
  • One Healthcare IDUHC and UMR
  • NaviNet (NantHealth)Multi-payer portal
  • Blue e
  • Tricare

Don't see a payer or service line you need?

We add new payer integrations every month. Tell us your top three, and we'll let you know exactly when each will be live.

Talk to us about a payer