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Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Jump to:
Categories
Solutions
Description
Compatibility Level
Clients
Use cases
EHR integrations
Client types
Awards
Differentiators
Keywords
Media
Company details
Direct
Direct

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Categories

Solutions

Description

Product Description:

This solution can automate the process of checking requests under review as well as continued status changes and updates. Supports many portals such as Evicore, Magellan, UHC and others. The solution includes business rules, exception handling and daily reporting functionality with customizable dashboard views. It is can be supported by CampTek as an ongoing managed service.

About CampTek Software:

CampTek Software is a Full-Life-Cycle Intelligent Automation SaaS Provider with proven results implementing and supporting automation solutions through our successful methodology. Our unique hosted model offers many powerful advantages including a shorter time to market, 24/7 support and overall lower cost of entry. Our approach is simple and repeatable.

CampTek will be with you on every step of your RPA & AI Journey!

Product Description:

Direct is the leading EHR-integrated cost transparency solution. The solution brings real-time, pharmacy benefit cost information, coverage restrictions, and alternatives into native EHR workflows. Giving providers cost information at the point-of-care enables data-driven and evidence-based decisions that help patients get the care they need at prices they can afford.

Features and Benefits:

 - Access to lower-cost alternatives increases care adherence and patient health and satisfaction

 - Select medications that do not require prior authorization

 - Reduced pharmacy/PBM/payer call-backs, prior authorization denials, and other uncompensated provider hassles

 - Uses native order workflows, is easy to implement

- Surfaces pharmacy alternatives to drive continuity of care and patient satisfaction

- Integrates patient affordability program offerings into RTPB results, showing best-cost options when insurance coverage isn't found or doesn't apply. 

About Arrive Health (RxRevu):

Arrive Health is a healthcare technology company dedicated to putting the needs of patients and providers first. We improve access to the most affordable, quality care by delivering accurate, patient-specific cost and coverage data to providers, care teams, and patients. Collaborating with premier health systems, pharmacy benefit managers, payers, and healthcare IT vendors, Arrive Health is clearing the way for better health by reducing friction in care workflows and enabling meaningful conversations about access to care. To learn more, please visit ArriveHealth.com.

Compatibility level

Select which hospital or health system you work at and see a personalized compatibility level.

Clients

Select which hospital or health system you work at and see the client list

Use Cases

Description:

Industries: Healthcare, RCM

Provider Systems: Epic

Payer Portals: eviCore, United Healthcare, Magellan

Challenge

A large healthcare provider needed to ramp up their automation strategy to offset labor instability and attrition. Currently the staff manually have to go out to payer portals, submit requests and check statuses of Prior Authorizations, sometimes multiple times. Through Task Mining AI (Artificial Intelligence) analysis, it was determined that staff were spending about 30 – 40% of their time submitting requests and checking the status for 19,000 prior authorizations per month.

Prior Authorization Requests: 3 bots processing prior authorization requests in 3 separate portals (EviCore, Magellan and UHC).

  • EviCore: 923 transactions per month
  • Magellan: 595 transactions per month
  • UHC: 7,063 transactions per month

Prior Authorization Statusing: 3 bots processing prior authorization statuses in 3 separate portals (EviCore, Magellan and UHC).

  • EviCore: 5,536 transactions per month
  • Magellan: 3,572 transactions per month
  • UHC: 986 transactions per month

 

Solution:

RPA bots are a much more accurate and effective solution to verify the status of patient health authorizations, RPA bots can repeatedly check requests under review for status changes and updates.

CampTek Software was engaged because of its healthcare and Epic experience. Through task mining, AI models were created, and results were reported back to the customer with enormous success. The next phase of design and build all occurred in a brief time. The bot now in production includes business rules, exception handling and daily reporting functionality. It is also supported by CampTek as an ongoing managed service solution for the provider.

The Bot is now saving 2,696 FTE (full-time employees) hours per month or 32,352 hours (about 3 and a half years) per year. The FTE capacity gain is 17 FTEs (full-time employees), and the ROI (Return on Investment) is $1,085,000 per year.

Pediatric use cases:

None provided

Users:

Any healthcare provider

Description:

With accurate coverage and cost information displayed at the point-of-care, providers can:

- Avoid medications that require prior authorization

- Improve patient interactions and experience

- Streamline ordering workflows

- Reduce patient costs and non-adherence 

- Support continuity of care

Pediatric use cases:

Deliver accurate costs and alternatives at the point-of-care. For children covered under a PBM/payer we're connected to, we can deliver details on medication options and restrictions. 

Users:

Any prescriber or care team member can utilize our solution within their EHR's workflow. 

EHR Integrations

Integrations:

Acute care EMR, Ambulatory EMR, Ancillary EMR, ERP system, Patient portal, Pop health platform, Home health, Behavioral health, Community based organizations, ADT, Access +/or revenue cycle, Credentialing, Website / public online sources, Other

EMR Integration & Relevant Hardware:

None provided

EMRs Supported:

Epic, Cerner, Meditech, Allscripts, NextGen, athena, GE, eClinicalWorks, McKesson, Other, Allscripts/Eclipsys, Athenahealth, Azalea Health/Prognosis, CPSI, Evident, Healthland, MEDHOST, MedWorx, QuadraMed, Self-developed, Would prefer not to disclose, Point Click Care

Hardware Compatibility:

None provided

Integrations:

Acute care EMR, Ambulatory EMR

EMR Integration & Relevant Hardware:

Required

EMRs Supported:

Epic, Cerner, Athenahealth

Hardware Compatibility:

Desktop, Mobile / Tablet (web optimized), Mobile / Tablet (native app)

Client Types

None provided

Awards

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Differentiators

Differentiators vs EHR Functionality:

We offer Intelligent Automation as a Managed Service and have successfully built automations for every major EHR.

Differentiators vs Competitors:

We not only focus on development but also full support of bots once they are in production. Each bot has its own custom dashboard view so that our customers are continuously informed of its daily trransaction metrics and KPIs.

Differentiators vs EHR Functionality:

Our solution is seamlessly embedded into EHR workflows, allowing for direct connections to payer and PBM source-of-truth data. EHRs typically allow for one or many connections to Real-Time Prescription Benefit solutions, but rarely have their own prescription price transparency capabilities built-in. 

Differentiators vs Competitors:

Arrive Health delivers the industry's most accurate, patient-specific cost and coverage information to the EHR. Many providers do not trust the pricing information displayed in their workflow because of its obsolete or incorrect nature (see whitepaper below). However, Arrive Health delivers data that providers can rely on, taking into consideration up-to-date copay and deductible information, benefit details, and preferred locations. We also display therapeutic alternatives that are covered under the patient's insurance, options that might not require prior authorization, and options at a health system's own internal pharmacy. 

Keywords

Images

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CampTek Methodology.jpg

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Videos

1 of 3

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Prior Authorization Request: EviCore

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Downloads

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Revenue Cycle Prior Authorization Case Study
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Arrive Health - Health System Flyer.pdf

Alternatives

Company Details

Founded in 2018

Founded in 2013

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