Accelerating Veradigm (Allscripts) Security Health Plan Prior Authorization Automation

Klivira delivers seamless Veradigm (Allscripts) Security Health Plan prior authorization automation, integrating directly with your EMR to accelerate approvals and reduce administrative burden across your organization.

Revenue cycle leaders and prior authorization coordinators at clinics and hospitals leveraging Veradigm's EMR portfolio face escalating demands managing prior authorizations, especially when navigating payer-specific requirements such as those from Security Health Plan. This complexity often leads to delays, denials, and increased operational costs, directly impacting patient care and financial performance.

Veradigm EMR Integration for Prior Authorization Workflows

Klivira integrates across the Veradigm EMR ecosystem, including TouchWorks EHR for larger physician groups, Professional EHR for smaller practices, and Sunrise for inpatient facilities. Leveraging the Veradigm Developer Program and FHIR APIs, Klivira accesses critical patient data from chart sections like Clinical Documentation, Orders activity, and Tasks to build comprehensive prior authorization requests. Our SMART App Launch capabilities enable a contextual workflow directly within the Veradigm clinical UI, reducing clicks and improving clinician efficiency.

Navigating Security Health Plan Prior Authorization Requirements

For healthcare organizations in Wisconsin, managing prior authorizations for Security Health Plan (Marshfield Security) is a critical operational task. Klivira's platform is engineered to streamline submissions and tracking for payers like Security Health Plan, ensuring that your practice adheres to their specific requirements. By automating the data assembly and submission process, we help reduce the administrative overhead associated with securing approvals from this Marshfield Clinic-affiliated insurer.

Automated Data Exchange and Submission

Klivira automates the extraction of necessary clinical data from your Veradigm EMR, compiling it into a payer-ready prior authorization packet for Security Health Plan. Whether the submission channel involves payer portals, ePA solutions, or other digital pathways, our system intelligently routes and monitors requests. This integration minimizes manual data entry, accelerates submission times, and provides real-time status updates directly within your existing workflows, enhancing transparency and control.

Key Prior Authorization Workflows Supported

Specialty drug prior authorizations (e.g., biologics, GLP-1s)
Advanced imaging (MRI, CT, PET) and diagnostic procedures
Surgical procedures and inpatient admissions
Durable medical equipment (DME) and home health services
Referrals to out-of-network specialists

Operational Benefits for Your Revenue Cycle

Implementing Klivira for Veradigm (Allscripts) Security Health Plan prior authorization automation translates directly into tangible benefits for your revenue cycle. Expect reduced administrative costs, improved prior authorization turnaround times, and a decrease in initial denial rates. This allows your prior authorization coordinators to focus on complex cases and patient advocacy, rather than repetitive data entry and manual follow-up.

Data Security and Compliance Considerations

Klivira adheres to stringent data security protocols, safeguarding all PHI exchanged between your Veradigm EMR and Security Health Plan. Our platform is designed with HIPAA compliance in mind, ensuring secure transmission and storage of sensitive patient information. We recommend discussing specific data privacy and security configurations with your internal compliance team to ensure alignment with your organizational policies.

Frequently asked questions

How does Klivira integrate with Veradigm's different EMR products?

Klivira integrates via the Veradigm Developer Program, leveraging FHIR R4 APIs and SMART App Launch capabilities. This allows us to connect with TouchWorks EHR, Professional EHR, and Sunrise, adapting to the specific integration surfaces and chart anatomies of each product line to extract and write back prior authorization data.

Can Klivira handle all types of prior authorizations for Security Health Plan?

Yes, Klivira's platform is designed to manage a broad spectrum of prior authorizations, including those for specialty medications, advanced imaging, surgical procedures, and more, regardless of the specific service line. Our system automates the preparation and submission of requests according to Security Health Plan's requirements.

What data is exchanged between my Veradigm EMR and Klivira for PA?

Klivira accesses relevant clinical and administrative data from your Veradigm EMR, such as patient demographics, diagnoses (Conditions), orders (ServiceRequest, MedicationRequest), encounters, and clinical documentation (DocumentReference). This data is securely transferred to build a comprehensive prior authorization request for Security Health Plan.

Will using Klivira reduce manual work for my prior authorization coordinators?

Absolutely. By automating data extraction, packet assembly, and submission tracking, Klivira significantly reduces the manual burden on your prior authorization coordinators. This allows them to allocate their time to more complex cases, peer-to-peer reviews, and direct patient support, optimizing your operational efficiency.

How does Klivira ensure data security and HIPAA compliance?

Klivira is built with robust security measures to protect PHI, adhering to industry best practices and HIPAA regulations. All data exchanges between your Veradigm EMR and payers like Security Health Plan are encrypted and secured. We maintain strict access controls and audit trails to ensure data integrity and confidentiality.