Summary:

Novoflow automates the submission of prior authorizations to eviCore navigating the complex clinical pathway questions and uploading evidence. The tool reduces the time staff spend on this notorious bottleneck accelerating approval for imaging and therapy.

Direct Answer:

eviCore is one of the most difficult benefit managers to navigate requiring detailed clinical answers and specific documentation. Staff often spend 20-30 minutes per case clicking through the wizard. A wrong answer can trigger an immediate denial.

Novoflow learns the clinical pathways for common procedures like MRIs or CTs. It extracts the relevant clinical data from the EHR notes and answers the portal questions automatically. It selects the correct diagnosis codes to match the medical necessity criteria.

This automation transforms the authorization process. Novoflow handles the repetitive heavy lifting with eviCore allowing staff to focus only on the complex cases that require a peer to peer review.