Elevating MEDITECH Fidelis Care Prior Authorization Automation

Accelerate patient access and improve revenue integrity with advanced **MEDITECH Fidelis Care prior authorization automation** from Klivira. Our platform streamlines the complex PA process, integrating directly with your EMR.

For healthcare organizations utilizing MEDITECH, particularly those serving Fidelis Care members in New York, navigating prior authorizations can be a significant operational bottleneck. The manual burden impacts staff productivity and delays patient care, especially for high-volume Medicaid and Medicare services.

Integrating with MEDITECH Expanse and Legacy Systems

Klivira's integration strategy for MEDITECH accounts for the variability across product lines. For **MEDITECH Expanse**, we leverage modern interfaces like **FHIR R4 APIs** and **SMART App Launch**, enabling a contextualized workflow directly within the EMR. For customers on **6.x, C/S, or Magic**, we often utilize established **HL7 v2 interfaces** for critical data exchange, ensuring broad compatibility.

Streamlining Prior Authorization for Fidelis Care Members

Fidelis Care, a Centene-owned plan serving New York's Medicaid and Medicare populations, requires prior authorization for a broad scope of medical and pharmacy services. Klivira automates the submission process, connecting to Fidelis Care through various channels, including direct electronic submissions, **X12 278 transactions**, and designated **ePA partners**, reducing manual portal interactions.

Optimizing High-Volume Workflows for NY Populations

Given Fidelis Care's focus, common PA workflows include advanced imaging, specialty pharmacy, and various inpatient or outpatient surgical procedures. Klivira's platform is designed to manage these high-volume requests efficiently, improving processing times and reducing administrative overhead for your staff.

Real-time PA Status and Documentation Exchange

Our solution provides real-time updates on prior authorization statuses, allowing PA coordinators to track requests without leaving the EMR. For MEDITECH Expanse, relevant PA artifacts, such as authorization numbers and decision letters, can be written back as **DocumentReference** objects or surfaced in **Surveillance/Worklists**, ensuring clinical and revenue cycle teams have immediate access to critical information.

Enhanced Efficiency for Revenue Cycle and PA Teams

By automating the prior authorization process for Fidelis Care within your MEDITECH environment, Klivira empowers your revenue cycle directors and PA coordinators to reallocate resources from manual tasks to patient care. This leads to fewer claim denials, faster reimbursement cycles, and a more streamlined operational flow, directly impacting your organization's financial health.

Frequently asked questions

How does Klivira connect to my MEDITECH EMR?

Klivira integrates with MEDITECH Expanse using **FHIR R4 APIs** and **SMART App Launch** for seamless contextual workflows. For legacy MEDITECH versions, we can integrate via **HL7 v2 interfaces** to ensure comprehensive data exchange across different product lines.

What PA channels does Klivira use for Fidelis Care?

Klivira automates submissions to Fidelis Care via multiple electronic channels, including **X12 278 transactions** and integrations with their **ePA partners**, minimizing manual portal work and accelerating the submission process.

Does Klivira support both medical and pharmacy PAs for Fidelis Care?

Yes, Klivira supports both medical and pharmacy prior authorizations for Fidelis Care, streamlining approvals across a wide range of services and medications relevant to their New York Medicaid and Medicare populations.

How does Klivira handle documentation for Fidelis Care PAs?

Klivira facilitates the assembly and submission of necessary clinical documentation from your MEDITECH system. This ensures that complete and accurate PA packets are sent to Fidelis Care, which helps reduce requests for additional information and speeds up decision times.

Is Klivira's integration with MEDITECH secure and compliant?

Yes, our integration with MEDITECH adheres to industry standards for data security and privacy, safeguarding PHI in compliance with HIPAA guidelines. We prioritize robust security measures for all EMR integrations.