Let auto-authorizations drive adoption to your best communications channel.
The most realistic way for health plans to keep up in today’s world of tightening budgets is to find efficiencies within their operations. It’s also imperative to foster strong relationships with providers to prevent resource-sapping abrasion. But are both possible?
In a word, yes. Using Essette Provider Portal, physicians and their staff can check member eligibility, submit authorization requests and referrals, and communicate with your care managers.
Best of all, you know providers will use the web-based platform. The easy-to-use interface integrates with the system to deliver expedited and often immediate authorizations for routine cases. Providers can attach relevant, evidence-based guideline content to their authorization requests and receive automated responses. This frees both your staff and providers’ staff to spend more time on improving patient outcomes, boosting efficiency and reducing abrasion.
What was once a time-consuming, manual process has been streamlined. With the Cite AutoAuth integration in the Essette Provider Portal, providers receive automatic determinations based on clinical criteria against the MCG evidence-based guidelines. This eliminates the time historically spent on faxing approvals back and forth between a provider and a health plan for a patient’s needed service or procedure. Ultimately, this results in better patient care.
Essette Provider Portal rests on the industry standard Microsoft .NET framework. Supported by a strong two-way communication process, the platform automatically routes more difficult cases to Essette Utilization Management. This integration means providers can review claims and patient care plans of all types with a single sign on.
Contact HMS today to find out how Essette Provider Portal can help you increase efficiency and reduce abrasion.