NextGen Healthcare Devoted Health Prior Authorization Automation

Klivira delivers end-to-end NextGen Healthcare Devoted Health prior authorization automation, integrating directly with your EMR to streamline complex workflows and accelerate approvals.

Revenue cycle teams and prior authorization coordinators utilizing NextGen Healthcare often face significant manual burdens when submitting authorizations to Devoted Health. Navigating payer-specific requirements and disparate submission channels for Medicare Advantage plans can lead to delays, denials, and increased administrative costs.

The Operational Burden of NextGen Healthcare and Devoted Health Prior Authorizations

NextGen Healthcare users, particularly within specialty ambulatory groups, encounter unique challenges with Devoted Health prior authorizations. Devoted Health's focus on Medicare Advantage plans often involves specific clinical criteria and submission pathways, requiring meticulous attention. The manual process of extracting patient data from NextGen, then re-entering it into payer portals or forms, consumes valuable staff time and introduces potential for errors.

Navigating Devoted Health's Prior Authorization Channels

Submitting prior authorizations to Devoted Health typically involves navigating their specific payer portals or manual submission processes. Without direct integration, this means staff must toggle between the NextGen EMR and external systems, manually transcribing information. Klivira centralizes this process, abstracting the complexities of varied payer requirements and submission methods into a unified workflow.

Klivira's Deep Integration with NextGen Healthcare

Klivira integrates directly with NextGen Healthcare, leveraging both its FHIR R4 API and SMART App Launch capabilities. This allows for seamless, context-aware data exchange, pulling essential clinical and administrative data (e.g., Patient, Encounter, Coverage, ServiceRequest, MedicationRequest, DocumentReference) directly from the NextGen EMR. Our solution supports write-back functionality via the NextGen API to deposit PA status updates and documentation.

Optimized Workflows for NextGen Healthcare and Devoted Health

Automated retrieval of patient demographics, encounters, and clinical history from NextGen.
Intelligent identification of Devoted Health's specific prior authorization requirements based on service codes and patient coverage.
Streamlined submission of medical and specialty pharmacy authorizations, including necessary clinical documentation.
Real-time status updates and tracking of Devoted Health prior authorization requests directly within the NextGen workflow.
Automated documentation of approval numbers and decision letters into the NextGen Patient Chart and Documents section.

Enhancing Prior Authorization Documentation within NextGen

Klivira ensures that all prior authorization artifacts are accurately and automatically recorded within the NextGen Healthcare EMR. Approved authorizations, denial reasons, and associated clinical documentation are deposited into the Patient Chart, Clinical Documents, Orders activity, and Tasks/Worklists sections, providing a comprehensive audit trail and supporting efficient follow-up.

Addressing NextGen Healthcare Deployment Specifics

Klivira's integration approach accounts for the inherent variability of NextGen Healthcare deployments, including both cloud-hosted and self-hosted models. Our solution is designed to support the needs of mid-size ambulatory practices, ensuring robust connectivity and performance regardless of the specific EMR deployment environment.

Frequently asked questions

How does Klivira integrate with my NextGen Healthcare EMR?

Klivira integrates with NextGen Healthcare primarily through its FHIR R4 API and SMART App Launch. This enables secure, contextual data exchange, allowing Klivira to pull necessary clinical and administrative data and write back authorization statuses and documentation directly into your EMR.

What specific data does Klivira exchange with NextGen Healthcare for prior authorizations?

Klivira exchanges key US Core FHIR resources relevant to prior authorizations, including Patient, Encounter, Coverage, ServiceRequest, MedicationRequest, DocumentReference, Practitioner, and Condition data, ensuring comprehensive clinical context for Devoted Health submissions.

How does Klivira handle Devoted Health's specific prior authorization requirements?

Klivira is designed to adapt to payer-specific rules, including those from Devoted Health. Our platform automates the identification of required documentation and submission pathways, centralizing the process and reducing the manual burden of navigating Devoted Health's Medicare Advantage authorization protocols.

Where will prior authorization documents and statuses appear in NextGen Healthcare after using Klivira?

Klivira ensures that all relevant prior authorization information, including approval numbers, decision letters, and status updates, is automatically recorded within your NextGen Healthcare EMR. This information is typically found in the Patient Chart, Documents/Clinical Documents, Orders activity, and Tasks/Worklists sections.

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

Yes, Klivira's integration strategy is built to accommodate the variability of NextGen Healthcare deployments, supporting both cloud-hosted and on-premise environments to ensure consistent prior authorization automation for mid-size ambulatory practices.