Automating DrChrono Naviguard Prior Authorizations with Klivira

Klivira directly integrates with DrChrono to automate prior authorization submissions for Naviguard, optimizing the utilization management process for UnitedHealthcare services.

For revenue cycle directors and prior authorization coordinators at small ambulatory and concierge practices utilizing DrChrono, managing Naviguard (UnitedHealthcare utilization management) requests can be a significant administrative burden. Klivira provides a purpose-built solution to streamline this workflow, reducing manual data entry and accelerating approval times.

Seamless DrChrono Integration for Naviguard Workflows

Klivira leverages DrChrono's robust integration surfaces, including the DrChrono API and FHIR endpoints, to establish a direct, secure connection. This allows for automated extraction of necessary clinical and demographic data directly from patient charts and order entries, initiating the Naviguard prior authorization process without requiring staff to navigate multiple systems.

Key DrChrono Data Elements for Naviguard Submissions

  • Patient demographics (e.g., name, DOB, insurance ID)
  • Diagnosis codes (ICD-10) from the problem list or encounter notes
  • Procedure codes (CPT/HCPCS) from order entry or billing modules
  • Clinical documentation, including progress notes and imaging reports
  • Referring and rendering provider information
  • Service dates and requested durations

Automating Naviguard Submission from DrChrono Order Entry

When a provider places an order within DrChrono that requires Naviguard prior authorization, Klivira's integration automatically identifies the requirement. Relevant data is extracted from the order, associated clinical templates, and the patient's record, compiling a comprehensive submission package. This eliminates the need for manual data transfer to the Naviguard portal.

Payer-Side Data Augmentation for UHC Naviguard Requirements

Beyond DrChrono's exposed data, Klivira actively pulls specific medical policies, plan requirements, and real-time status updates directly from the UHC Naviguard portal. This ensures that submissions are tailored to current payer guidelines, reducing the likelihood of denials due to incomplete or misaligned information. Approved authorizations, including reference numbers, are then pushed back into the DrChrono patient record.

Enhancing Efficiency in DrChrono for UHC Naviguard Utilization Management

By automating the DrChrono Naviguard workflow, practices can reallocate staff from administrative tasks to patient care. Klivira's system provides a centralized dashboard for tracking all UHC Naviguard authorizations, offering transparency and reducing the time spent on follow-ups. This leads to faster service delivery and improved revenue cycle performance.

Frequently asked questions

How does Klivira integrate with DrChrono for Naviguard prior authorizations?

Klivira integrates directly with DrChrono using its DrChrono API and FHIR endpoints. This allows for secure, automated extraction of patient demographics, clinical data, and order details, which are then used to populate and submit Naviguard prior authorization requests.

What specific data does Klivira pull from DrChrono for Naviguard submissions?

Klivira pulls essential data such as patient demographics, ICD-10 diagnosis codes, CPT/HCPCS procedure codes from order entries, and relevant clinical documentation from DrChrono. This ensures that all necessary information for a comprehensive Naviguard submission is gathered efficiently.

Can Klivira handle the specific utilization management requirements of Naviguard?

Yes, Klivira is designed to manage the unique requirements of various payers, including Naviguard (UHC). Our platform stays updated with Naviguard's specific medical policies and submission guidelines, ensuring that authorizations are submitted accurately and completely to reduce denials.

How does Klivira update DrChrono with the status of Naviguard authorizations?

Klivira monitors the Naviguard portal for status updates. Once an authorization decision is made, Klivira automatically retrieves the status, approval numbers, and any associated documentation, pushing this information back into the corresponding patient's record within DrChrono, maintaining a single source of truth.

Is PHI secure during the DrChrono-Naviguard integration process?

Yes, Klivira prioritizes the security and privacy of PHI. Our integration with DrChrono and interaction with payer portals adhere to industry-standard security protocols and best practices, ensuring that all data transfers are encrypted and compliant with HIPAA regulations.

Related coverage

Other drchrono prior auth coverage

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