Achieve Epic Prior Authorization Automation with Klivira

Klivira delivers robust Epic prior authorization automation, directly integrating with your Epic EHR environment to reduce administrative burden and accelerate time to care.

For revenue cycle directors, prior authorization coordinators, and IT integration leads at large health systems and academic medical centers using Epic, navigating the complexities of prior authorization can be a significant drain on resources. Manual workflows, context switching out of Hyperspace, and fragmented payer portal access contribute to delays and denials. Klivira addresses these challenges by embedding automation directly into your Epic ecosystem.

Seamless Integration with Epic's Core Workflows

Klivira leverages Epic's advanced integration surfaces to embed prior authorization automation directly into your clinical and administrative workflows. This means less context switching and more efficient processing, right where your clinicians and staff operate within Hyperspace or Hyperdrive.

Key Integration Pathways with Epic

**SMART on FHIR**: Klivira utilizes SMART App Launch (src: smart-app-launch) for EHR-launched workflows from within Hyperspace/Hyperdrive, providing patient and encounter context directly to the application.
**FHIR R4 APIs**: We connect via Epic's FHIR R4 read APIs for critical resources like Coverage, ServiceRequest, and DocumentReference (src: epic-on-fhir), and leverage write APIs for specific resources to deposit PA packets.
**CDS Hooks**: For real-time PA detection, Klivira can integrate with `order-select` and `order-sign` CDS Hooks (src: cds-hooks), supporting Da Vinci CRD-relevant workflows (src: davinci-crd-ig) to surface requirements at the point of order entry.
**HL7 v2 Interfaces**: While FHIR is preferred, we support HL7 v2 interfaces for ADT and other feeds, ensuring compatibility with existing Epic implementations.
**App Orchard / Showroom Engagement**: Klivira is actively engaged with the Epic ecosystem via the App Orchard, which is transitioning to Epic Showroom (src: epic-showroom), ensuring our integration adheres to Epic's standards.

Addressing Prior Authorization Pain Points in Epic

Our integration directly targets the common pain points experienced by Epic users. By automating manual fax workflows, minimizing context switching, and consolidating fragmented payer portal access, Klivira helps reduce the administrative burden of prior authorizations. This allows your team to focus on patient care rather than paperwork.

Enhancing PA Visibility and Workflow within Epic

**Clinical Documentation**: Access and aggregate supporting clinical documentation from Chart Review (Notes, Imaging, Labs, Documents tabs) via FHIR DocumentReference and DiagnosticReport queries.
**Order Entry Integration**: Surface coverage requirements and initiate PA workflows at the point of order entry within the Orders activity, leveraging CDS Hooks.
**PA Packet Management**: Deposit partner-supplied PA packets and related attachments directly into the patient's Media section or as DocumentReference entries, visible to Epic users.
**Status Updates**: Route PA status updates, peer-to-peer review requests, and other workflow items to the appropriate clinician or coordinator via Epic's Inbasket module.
**At-a-Glance Summary**: Support visibility of coverage status and active PA cases within the Storyboard for quick reference.

Navigating Epic's Integration Landscape

Klivira understands the nuances of integrating with Epic. We account for per-customer production endpoints, varying customer configurations, and the evolving landscape of Hyperspace vs. Hyperdrive browser models. Our approach ensures robust, adaptable integration that aligns with your specific Epic deployment, including adherence to USCDI standards (src: epic-uscdi) and ONC certification requirements (src: onc-chpl).

Frequently asked questions

How does Klivira access patient data from Epic for prior authorizations?

Klivira securely accesses patient data from Epic primarily through FHIR R4 read APIs (src: epic-on-fhir), specifically for US Core (src: us-core) resources like Patient, Coverage, ServiceRequest, and DocumentReference. This ensures we gather all necessary clinical documentation while adhering to Epic's robust security protocols.

Can Klivira write back prior authorization status or documents into Epic?

Yes, Klivira supports write-back capabilities where Epic's FHIR write API surface allows. This includes depositing submitted prior authorization packets as DocumentReference resources (src: epic-on-fhir) and routing status updates or task assignments to relevant users via Epic's Inbasket. The specific write capabilities are verified against your Epic version and configuration.

Does Klivira integrate with Epic's CDS Hooks for real-time PA checks?

Absolutely. Klivira can integrate with Epic's CDS Hooks (src: cds-hooks), particularly `order-select` and `order-sign` hooks relevant to Da Vinci CRD (src: davinci-crd-ig). This allows for proactive identification of prior authorization requirements at the point of order entry, preventing downstream delays.

Is Klivira available through Epic's App Orchard or Showroom?

Klivira is actively engaged in the Epic ecosystem through the App Orchard, which is transitioning to Epic Showroom (src: epic-showroom). Our technical integration aligns with Epic's developer program standards, and we work with health systems to facilitate the necessary provisioning for our application within their Epic environment.

How does Klivira handle the variability of Epic customer configurations?

We recognize that each Epic customer has unique configurations, including specific FHIR base URLs and varying resource access permissions. Klivira's integration approach is designed to be flexible, dynamically discovering endpoints via the SMART well-known configuration and adapting to the specific capability statement of each Epic instance to ensure seamless operation.