NextGen Healthcare Prior Authorization Automation

Klivira delivers robust NextGen Healthcare prior authorization automation, streamlining processes directly within your existing EMR environment to enhance operational efficiency.

Revenue cycle leaders and prior authorization coordinators face increasing pressure to manage the complex and time-consuming PA process. Integrating a specialized automation platform with NextGen Healthcare is critical for reducing administrative burden, improving turnaround times, and ensuring timely reimbursement for specialty ambulatory groups.

Seamless Integration with NextGen Healthcare

Klivira leverages NextGen's robust integration surfaces, including the NextGen Healthcare API and FHIR R4 endpoints, to ensure seamless data exchange (src: nextgen-developer). This approach enables bidirectional flow of clinical and administrative data, critical for automating prior authorization workflows without disrupting established clinical processes.

Optimizing Prior Authorization Workflows within NextGen

Our platform is designed to embed prior authorization intelligence directly into your NextGen environment. By utilizing SMART App Launch, Klivira can initiate workflows with patient and encounter context directly from the NextGen clinical UI (src: smart-app-launch), reducing context switching for your PA coordinators.

Key Integration Points in NextGen EMR

Patient Chart: Centralized view for clinical data and PA status.
Documents/Clinical Documents: Automated deposition of supporting clinical documentation and PA packets.
Orders Activity: Integration with order entry workflows for proactive PA detection.
Tasks/Worklists: Assignment and tracking of PA-related follow-up actions.

Leveraging NextGen's FHIR Capabilities for PA

Klivira utilizes NextGen's FHIR R4 read capabilities, specifically US Core resources, to access essential data for prior authorizations (src: us-core). This includes patient demographics, encounters, coverage details, service requests, medication requests, and relevant clinical documents, ensuring comprehensive data availability for submission.

Addressing Deployment Variability for Specialty Groups

Recognizing NextGen's popularity in mid-sized specialty ambulatory groups, Klivira's integration accounts for both cloud-hosted and self-hosted deployment models. This flexibility ensures that regardless of your NextGen infrastructure, Klivira can be configured to support your specific prior authorization automation needs.

Frequently asked questions

How does Klivira integrate with NextGen Healthcare?

Klivira integrates with NextGen Healthcare primarily through its NextGen Healthcare API and FHIR R4 endpoints (src: nextgen-developer). This allows for secure, bidirectional data exchange, enabling automation of prior authorization workflows directly within your EMR.

Where do prior authorization documents appear in the NextGen EMR after Klivira processes them?

Klivira deposits supporting clinical documentation and complete prior authorization packets directly into the "Documents/Clinical Documents" section of the NextGen Patient Chart. This centralizes all relevant PA artifacts for easy access by your care team.

Does Klivira support SMART on FHIR with NextGen?

Yes, Klivira supports SMART App Launch capabilities with NextGen (src: smart-app-launch). This enables the Klivira application to be launched directly from within the NextGen clinical UI, providing patient and encounter context for a streamlined user experience.

What types of data does Klivira exchange with NextGen for prior authorizations?

Klivira exchanges critical data points such as patient demographics, encounter details, coverage information, service and medication requests, and clinical documentation using NextGen's FHIR R4 US Core resources (src: us-core). This ensures comprehensive data for accurate PA submissions.

Is Klivira compatible with both cloud and on-premise NextGen deployments?

Yes, Klivira's integration strategy is designed to accommodate the variability of NextGen deployments, supporting both cloud-hosted and self-hosted environments. This ensures flexibility for specialty ambulatory groups regardless of their specific infrastructure.