Real-Time EDI 278 Prior Authorization for Providers and Payersadmin2015-08-11T05:07:09+00:00
Real-Time Prior Authorization Provider Solutions
Provider Portal: Automated Prior Authorization Saves Significant Cost and Processing Time
Provider Benefits
- Single point of access to all payers in provider’s network to check eligibility (270) and submit prior authorization (278) requests
- Eliminates multiple logins to individual payer sites and automates the entire prior authorization process
- Before submission, prior authorizations are reconciled against payer policies to reduce possibility of denials
- Automated real-time prior authorization saves significant cost, processing time, and accelerates patient throughput
- Simple, intuitive clinical workflow designed from the provider’s perspective
- Accelerates revenue capture and operational cash flow
- Fully based on the EDI 278 protocol, mandated by the ACA to be adopted by all payers January 1, 2016
Automated Referral and Prior Authorization Workflow
For Payers: Real Time 278 EDI Adjudication Engine For Prior Authorization
Payer Benefits
- Automated prior authorization adjudication reduces cost by order of magnitude, improves response time, expands usage, and helps controls fraud
- Significant increase in workflow efficiency, transaction volumes, time-savings, and responsiveness
- All payers need to adjudicate prior authorization requests based on EDI 278 protocol, as mandated by the ACA by January 1, 2016
- Advanced analytics modules help enforce appropriate use medicine and maximize outcomes per dollar spent
- IIC’s adjudication engine solution offers all payers a more competitive product offering