Streamlining Epic Devoted Health Prior Authorization Automation

Klivira drives Epic Devoted Health prior authorization automation, directly addressing the complexities of Medicare Advantage PAs from within your Epic EMR.

For revenue cycle directors, prior authorization coordinators, and IT integration leads, navigating prior authorization for Devoted Health's Medicare Advantage plans from Epic Systems can be a significant administrative burden. Manual workflows, context switching, and fragmented payer portal access lead to delays and increased denial rates. Klivira offers a targeted solution to these challenges.

The Challenge: Devoted Health PAs from Epic

Health systems leveraging Epic often face a common set of prior authorization pain points, including reliance on manual fax workflows and the necessity to context-switch out of Hyperspace or Hyperdrive. When coupled with the specific requirements of Medicare Advantage plans from Devoted Health, these challenges are amplified, impacting turnaround times and staff productivity. Fragmented payer portal access further complicates the process, making comprehensive PA management difficult.

Seamless Integration with Epic EMR

Klivira integrates deeply with Epic, utilizing industry-standard mechanisms to embed prior authorization workflows directly into the clinician experience. Our platform leverages SMART on FHIR for secure, context-aware launches from Hyperspace or Hyperdrive, ensuring patient and encounter data are seamlessly transferred. We utilize FHIR R4 read capabilities for US Core resources like ServiceRequest, MedicationRequest, and DocumentReference, and support write-back for DocumentReference, Communication, and Task resources to keep Epic updated.

Automating Devoted Health Medicare Advantage PAs

Devoted Health, with its focus on Medicare Advantage, requires precise and timely prior authorization submissions. Klivira automates the aggregation of necessary clinical documentation from Epic's Chart Review, Media, and Orders activity. This includes critical data points from DiagnosticReport, Observation, and Condition resources. By streamlining the collection and submission process, Klivira helps ensure that Devoted Health receives complete and accurate PA requests, reducing the likelihood of denials related to insufficient information.

Key Klivira Capabilities for Epic + Devoted Health

Our platform is engineered to optimize the prior authorization lifecycle for this specific EMR-payer pairing, addressing common operational hurdles and enhancing efficiency.

Specific Workflow Enhancements:

**Embedded Workflow**: Launch Klivira directly from Epic's Hyperspace or Hyperdrive via SMART App Launch, maintaining context within the EMR.
**Automated Data Aggregation**: Automatically pull relevant clinical data from Epic's Chart Review, Media, and Orders activity for Devoted Health submissions.
**Real-time Status Updates**: Push prior authorization status updates back into Epic's Inbasket or as Communication/Task entries.
**Documentation Write-back**: Deposit complete PA packets and authorization numbers as DocumentReference entries within the Epic patient chart.
**Proactive PA Detection**: Utilize CDS Hooks (e.g., `order-select`, `order-sign`) to identify Devoted Health PA requirements at the point of order entry in Epic.

Addressing Complex Medicare Advantage PA Requirements

Medicare Advantage plans often have specific prior authorization requirements for specialty medications, advanced imaging, and complex surgical procedures. Klivira's integration with Epic's Orders activity and comprehensive documentation aggregation capabilities ensure that all necessary information, such as clinical notes, diagnostic reports, and medication history, is captured and presented for Devoted Health's review. This reduces manual effort and accelerates approval times for high-cost services.

Frequently asked questions

How does Klivira integrate with Epic to gather documentation for Devoted Health PAs?

Klivira uses Epic's FHIR R4 read APIs to access relevant clinical documentation from modules like Chart Review, Media, and Orders activity. This includes resources such as DocumentReference, DiagnosticReport, and Observation, ensuring all necessary information is aggregated for Devoted Health submissions.

Can Klivira help identify Devoted Health PA requirements within Epic's workflow?

Yes, Klivira can leverage Epic's support for CDS Hooks, including `order-select` and `order-sign`, to surface Devoted Health prior authorization requirements at the point of order entry within Hyperspace or Hyperdrive, aligning with Da Vinci CRD-aware workflows.

How does Klivira send prior authorization status updates back to Epic for Devoted Health cases?

Klivira supports FHIR R4 write capabilities for Communication and Task resources, enabling automated status updates to be pushed back into Epic's Inbasket or other relevant areas of the patient chart. Authorization numbers and final PA packets can also be written back as DocumentReference entries.

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

Klivira is designed to integrate seamlessly with Epic's ecosystem. We follow the technical guidelines for partner applications, including SMART on FHIR and FHIR R4 API utilization, and are pursuing listing through Epic's Showroom (formerly App Orchard) program to ensure validated integration for our customers.

How does Klivira handle the specific nuances of Devoted Health's Medicare Advantage prior authorization process?

While specific payer policies are dynamic, Klivira's platform is built to adapt to diverse payer requirements. For Devoted Health, our automation focuses on efficient data aggregation from Epic, intelligent form completion, and structured submission workflows, which are critical for navigating Medicare Advantage prior authorization complexities and reducing manual errors.