Sold by: Deloitte Consulting (US)Â
CareClarity is a health care prior authorization solution designed to reduce administrative burden on providers and facilitate necessary approval required to deliver patient care in a timely manner. The application leverages a robust rules engine to produce real-time determination, gather payor specific requirements used to fetch EHR data and auto-populate prior authorization forms. Featuring an intuitive questionnaire and document UI the application streamlines submission protocols to achieve optimal payor response times and mitigate downstream denials.
Overview
CareClarity and the AWS platform together create a powerful synergy that maximizes the efficiency of health care management. Leveraging AWS's cloud infrastructure, CareClarity delivers scalable, secure, and high-performance approval processes for health care providers and payors. The integration of various AWS services can enhance data processing speed, storage, and accessibility, while a robust rules engine streamlines decision-making and approval workflows. This combination can not only accelerate the approval process but can also help ensure smooth, efficient, and cost-effective operations, providing a comprehensive solution that drives improved patient outcomes and operational efficiency in health care management. Automated prior auth approval workflows in CareClarity reduce manual processing time and effort. Using advanced algorithms and predefined criteria, CareClarity can quickly generate requests based on clinical guidelines and payor policies. This can dramatically reduce upfront utilization while minimizing human error, which can lead to timely patient care and lower denial rates. Real-time data integration in CareClarity allows synchronization to current patient information, medical records, and treatment histories. This can enable health care providers to make quick, informed decisions. Additionally, it can help ensure that any changes in patient status or new medical information are immediately refreshed in CareClarity, enhancing accuracy and relevance prior to case submission. CareClarity improves administrative efficiency by reducing staff utilization from calls to the payor, case rework, and denial follow-up. In turn this allows the staff to focus more time directly on the patient, improving the overall patient experience and timely access to care.
Reach out to learn how Deloitte's CareClarity solution can help your health care organization reduce the burden of prior authorization. Sam Johnson, Principal, Deloitte Consulting LLP - samjohnson@deloitte.com Ted Davis, Product Manager, Deloitte Consulting LLP - tedavis@deloitte.com Jay Rajendran, Engineering Manager, Deloitte Consulting LLP - jayrajendran@deloitte.comÂ
Highlights
- Enables real-time identification of prior authorization necessity and medical documentation requirements for health care services based on payor specific determination rules.
- Automates workflows and monitors likely outcome through an intuitive questionnaire and document UI to guide staff through the completion of forms and uploading relevant documents.
- Provides a streamlined submission process through a single portal within seconds by auto populating EHR data and pre-filling prior authorization forms.
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