Greenway Health SCAN Health Plan Prior Authorization Automation

Klivira provides comprehensive Greenway Health SCAN Health Plan prior authorization automation, streamlining the often-complex process for ambulatory practices managing Medicare Advantage patients.

For ambulatory practices utilizing Greenway Health's Intergy or Prime Suite, navigating prior authorizations for SCAN Health Plan's Medicare Advantage members presents distinct challenges. The manual submission processes, often involving the SCAN provider portal or fax, divert staff time from patient care and can lead to approval delays. Klivira addresses these operational inefficiencies by automating critical steps.

The Challenge of SCAN Health Plan Prior Authorizations from Greenway

Ambulatory practices using Greenway Health's EHRs, such as Intergy or Prime Suite, frequently encounter friction when processing prior authorizations for SCAN Health Plan members. Given SCAN's focus on Medicare Advantage, the PA process often involves specific requirements for senior care services and medications, typically necessitating direct engagement with the SCAN provider portal or traditional X12 278 transactions if supported, or even faxes for non-standard requests.

Klivira's Integration with Greenway Health

Klivira integrates directly with Greenway Health's ambulatory EHR platforms, including Intergy and Prime Suite, through the Greenway Marketplace. This deep integration allows Klivira to pull patient demographics, clinical documentation, and order details directly from the EHR, eliminating the need for manual data entry into separate PA systems.

Streamlining SCAN Health Plan PA Workflows

Klivira optimizes prior authorization workflows specifically for SCAN Health Plan's Medicare Advantage population. This includes automating submissions for high-cost specialty medications, advanced imaging (e.g., MRI, CT scans), durable medical equipment (DME), and specific surgical procedures often covered under Medicare Advantage plans. Our system intelligently routes requests via the most efficient path, whether through ePA standards like NCPDP SCRIPT, X12 278 where available, or direct portal automation.

Key Benefits for Greenway Health Users

Automated data extraction from Greenway Intergy and Prime Suite, minimizing manual entry errors.
Accelerated submission to SCAN Health Plan via optimized pathways, including ePA and portal automation.
Real-time status tracking for all SCAN Health Plan prior authorizations directly within Klivira.
Reduced administrative burden on PA coordinators, allowing focus on complex cases.
Enhanced visibility into PA status across your ambulatory practice.

Addressing Specific SCAN Health Plan Service Lines

For SCAN Health Plan, Klivira specifically targets high-volume or high-cost service lines prevalent in senior care. This includes prior authorizations for biologics and specialty drugs used in chronic disease management, advanced diagnostic imaging crucial for geriatric assessments, and referrals to specialists or skilled nursing facilities. Our platform ensures that necessary clinical documentation from Greenway is correctly assembled and submitted to meet SCAN's specific medical policies.

Ensuring Data Security and Compliance

Klivira's platform is designed with robust security protocols to protect PHI and ePHI throughout the prior authorization process. Our integrations adhere to industry best practices for data exchange, ensuring secure communication between Greenway Health EHRs and SCAN Health Plan's systems. Organizations should discuss Klivira's security architecture with their compliance teams.

Frequently asked questions

How does Klivira integrate with Greenway Health?

Klivira integrates directly with Greenway Health's Intergy and Prime Suite EHRs via the Greenway Marketplace. This allows for seamless, secure extraction of patient demographics, clinical notes, and order details necessary for prior authorization submissions.

Can Klivira handle all types of SCAN Health Plan prior authorizations?

Yes, Klivira is designed to manage a broad spectrum of prior authorizations for SCAN Health Plan members, covering specialty medications, advanced imaging, DME, and various surgical or procedural requests common in Medicare Advantage plans. Our system adapts to SCAN's specific submission requirements.

Does Klivira connect directly to the SCAN Health Plan portal?

Klivira employs multiple pathways for submission to SCAN Health Plan, including direct ePA standards like NCPDP SCRIPT and X12 278 where supported, as well as intelligent portal automation for payer-specific portals. This ensures the most efficient route for each authorization request.

How does Klivira improve turnaround times for SCAN Health Plan PAs?

By automating data extraction from Greenway, ensuring complete submissions, and intelligently routing requests through the fastest available channels (e.g., ePA vs. portal automation), Klivira significantly reduces the manual steps and potential errors that often delay SCAN Health Plan prior authorizations, leading to faster approvals.

Is Klivira compliant with HIPAA for Greenway and SCAN data exchange?

Klivira is built with stringent security measures to protect PHI and ePHI, adhering to HIPAA guidelines for data privacy and security. Our integrations with Greenway Health and SCAN Health Plan are designed for secure data exchange, and we encourage organizations to review our security protocols with their compliance officers.