Veradigm (Allscripts) LifeWise Prior Authorization Automation

Klivira streamlines Veradigm (Allscripts) LifeWise prior authorization automation, integrating directly into your EMR to reduce manual effort and accelerate approvals.

Revenue cycle leaders and prior authorization coordinators face significant challenges managing diverse payer requirements and EMR workflows. For organizations utilizing Veradigm's portfolio of EMRs, including TouchWorks EHR, Professional EHR, and Sunrise, coordinating prior authorizations for LifeWise commercial plans demands a precise, integrated approach to maintain efficiency and minimize denials.

Navigating LifeWise Prior Authorization from Veradigm EMRs

LifeWise, a commercial insurer affiliated with Premera, requires prior authorization for various medical services and medications. Clinicians within Veradigm EMRs typically initiate orders through the 'Orders activity' or 'e-Prescribing' modules, which then trigger the need for PA. Manually navigating LifeWise's specific requirements from these disparate systems can lead to delays and administrative burden.

Klivira's Integration with Veradigm (Allscripts) EMRs

Klivira integrates with Veradigm's EMR portfolio by leveraging the Veradigm Developer Program and its FHIR API capabilities. For modern Veradigm product lines like TouchWorks EHR and Professional EHR, Klivira can deploy as a SMART App, launching directly from the clinical UI with patient context. For hospital systems utilizing Sunrise, or for workflows requiring broader data access, Klivira also supports the Veradigm Unity API and HL7 v2 interfaces, adapting to the specific EMR's integration surface.

Key Data Exchange Points for Veradigm (Allscripts) EMRs

Patient demographics and Encounter details via FHIR R4 US Core resources.
Coverage information to verify payer eligibility and benefits.
ServiceRequest and MedicationRequest data for precise authorization submissions.
Clinical documentation from 'Clinical Documentation / Notes' via FHIR DocumentReference.
Practitioner and Condition data to support medical necessity.
Write-back of PA status and approval documents into the patient chart and 'Tasks / Worklists'.

Streamlining LifeWise Commercial PA Workflows

Klivira automates the prior authorization submission process for LifeWise commercial plans. By extracting necessary clinical and administrative data directly from your Veradigm EMR, Klivira can prepare and submit authorization requests through available ePA channels or via intelligent portal automation. This reduces the manual data entry burden on prior authorization coordinators and accelerates the submission timeline.

Addressing Specialty-Specific Prior Authorization Needs

Whether for high-cost specialty medications, advanced imaging, or complex surgical procedures, Klivira is configurable to handle diverse prior authorization requirements. The platform ensures that all necessary clinical documentation, pulled from your Veradigm EMR, is accurately packaged and submitted to LifeWise, helping to prevent denials related to incomplete information.

Ensuring Data Integrity and Compliance

Klivira's integration with Veradigm EMRs is designed with data security and compliance as paramount. Leveraging FHIR R4 and adhering to industry best practices for secure data exchange, Klivira helps ensure the integrity of PHI throughout the prior authorization process. Organizations should discuss specific integration configurations and data flows with their compliance teams to ensure alignment with HIPAA and organizational policies.

Frequently asked questions

How does Klivira integrate with my specific Veradigm EMR (e.g., TouchWorks, Professional EHR, Sunrise)?

Klivira leverages the Veradigm Developer Program and FHIR R4 APIs, including SMART App Launch, to integrate directly. This allows patient context to be passed from your EMR's clinical UI for a seamless experience. Integration specifics may vary slightly across TouchWorks EHR, Professional EHR, and Sunrise due to their distinct architectures and available API surfaces.

What types of prior authorizations can Klivira automate for LifeWise?

Klivira is designed to automate a broad range of commercial prior authorizations for LifeWise, including those for specialty medications, imaging services, and surgical procedures. Our platform adapts to LifeWise's specific requirements, whether through electronic channels or intelligent portal automation, to ensure comprehensive coverage.

How does Klivira handle updates and status tracking for LifeWise PAs?

Klivira automates the retrieval of status updates from LifeWise and can route these directly back into your Veradigm EMR's workflow systems, such as 'Tasks / Worklists'. This ensures your prior authorization coordinators have real-time visibility into authorization statuses without the need for manual portal checks, improving operational efficiency.

Does Klivira support write-back of prior authorization documentation into Veradigm EMRs?

Yes, Klivira supports the write-back of prior authorization artifacts, such as approval letters or submitted documentation packets, into the Veradigm EMR. This typically utilizes FHIR DocumentReference resources, ensuring all PA-related information is centrally located within the patient chart and accessible to clinical staff.

Is Klivira's integration with Veradigm (Allscripts) ONC Cures Update API compliant?

Klivira's integration is designed to align with the data exchange capabilities provided by Veradigm's FHIR R4 APIs, which are part of their ONC Cures Update API certification for modern product lines. We leverage US Core resources to ensure compliant data access and exchange, supporting interoperability requirements.