Oracle Health (Cerner) SCAN Health Plan Prior Authorization Automation

The Challenge of Oracle Health (Cerner) and SCAN Health Plan Prior Authorizations

Healthcare organizations utilizing Oracle Health (Cerner) face significant operational hurdles when processing prior authorizations for SCAN Health Plan members. The manual effort required to extract patient data from PowerChart, access SCAN's specific requirements, and submit through various channels leads to delays and high administrative costs. This is particularly acute for SCAN Health Plan's Medicare Advantage focus, where timely approvals are critical for senior care.

Klivira's Deep Integration with Oracle Health (Cerner)

Klivira integrates directly with Oracle Health (Cerner) via robust, modern interfaces to embed prior authorization workflows seamlessly into the clinical desktop. Leveraging SMART App Launch, our application can be initiated directly from PowerChart, providing patient and encounter context at launch. We utilize FHIR R4 APIs for secure data exchange, including US Core resources like Coverage, ServiceRequest, MedicationRequest, and DocumentReference. For comprehensive coverage, Klivira also supports HL7 v2 interfaces, ensuring compatibility with existing production deployments, and employs CDS Hooks to surface PA requirements at the point of order entry.

Streamlining SCAN Health Plan Prior Authorizations

Klivira automates the prior authorization process for SCAN Health Plan by connecting to their diverse submission channels. This includes support for electronic prior authorization (ePA) standards like X12 278 and NCPDP SCRIPT, as well as direct connectivity to payer portals. Our platform intelligently routes requests based on SCAN's specific requirements, reducing the need for manual data entry and minimizing payer portal fatigue. This ensures that authorizations for SCAN's Medicare Advantage members are processed efficiently and accurately.

Key Prior Authorization Workflows for SCAN Health Plan Members

For SCAN Health Plan's Medicare Advantage population, Klivira focuses on automating high-volume and high-impact prior authorization workflows. This includes medical necessity reviews for specialized procedures, advanced imaging, and specialty medications often prescribed for chronic conditions common in senior care. By automating these critical pathways, Klivira helps ensure timely access to necessary services for SCAN members while reducing administrative burdens on your staff.

Benefits of Klivira's Oracle Health (Cerner) SCAN Health Plan Automation

• Eliminate PowerChart context switching by embedding PA workflows directly.
• Reduce manual data entry and fax-heavy processes for SCAN Health Plan submissions.
• Accelerate prior authorization turnaround times for Medicare Advantage members.
• Improve data accuracy and compliance with SCAN's specific requirements.
• Enhance staff productivity by automating routine PA tasks.
• Gain real-time visibility into the status of all SCAN Health Plan prior authorizations.

Ensuring Data Integrity and Compliance

Klivira prioritizes the secure and compliant handling of ePHI throughout the prior authorization process. Our integrations with Oracle Health (Cerner) and SCAN Health Plan adhere to industry standards for data security. Organizations should review their specific configuration with their compliance teams to ensure all workflows align with HIPAA regulations and other relevant CMS guidelines for Medicare Advantage plans.