Prior Authorization Software, ePrescribing, Electronic Medical Records, Physician Practice Automation

Key Features
	Enterprise solution to streamline and manage Prior Authorizations
Prescription drugs, DME, and medical procedures. more
Manage PAs for Prescription drugs, DME, Radiology and medical procedures Easy integration with enterprise systems (Eligibility, Customer Service, etc..) Integrates with ePrescribing and physician portals Electronic processing of authorizations and notifications Advanced and flexible episode of coverage clinical rules Prioritization by urgency and specific plan rules Online audit and operational reporting capabilities

	Clinical Rules Management
Map healthcare services to plan coverage rules. more
Map healthcare services to plan coverage rules Accommodates variations of your guidelines by healthcare service and LOB rules Automated Decision Rules Engine Supports First Data Bank and Medispan drug files Supports CPT, HCPCS, and ICD9 codes Rules-driven authorization parameters
	Distributed workflow - Review anywhere
Integrated Queue Manager routes work to... more
Integrated Queue Manager routes work to appropriate roles and resources Compliance repository used to prioritize and automate processing Advanced electronic document management (EDM) features Smart PA forms scanned, imaged and attached to Episodes of Coverage Facilitates electronic collaboration between RPh., Nurse, and Physicians Custom queues to support unique operational workflows
	Comprehensive Document Management.
Automated generation, delivery and archival. more
Automated generation, delivery and archival Integrated faxing eliminates need for expensive fax servers User controlled template design and content Rules driven template selection based on plan and outcome rules Attachment of electronic documentation to prior authorization requests Electronic and traditional delivery channels with tracking support

	ePrescribing and Physician Portal support.
Online Physician access to submit PA requests. more
Online Physician access to submit PA requests Customized messaging to physicians for formulary and therapy alternatives Ability for physicians to answer criteria questions at Point of Care Upload supporting documentation with the request submission or response Retrieve request status and communications via the Portal

Key Features