At Casenet, we understand that providers submit large numbers of prior authorizations each week, and that they often have to wait more than a day for a decision. The process is often complex and leads to frustration. We also know that different health plans have different business rules.
This is where TruCare ProAuth comes in. This interactive digital authorization management tool is designed to make the authorization process easy for providers and display real-time updates regarding prior authorization decisions from the plan. For plans, authorizations can be automatically approved based on rules about providers, diagnoses, procedures, services, service thresholds, and other information in the authorization request.
When using ProAuth, providers need enter only minimal information to confirm if an authorization is required. When authorizations aren’t required, or if a duplicate authorization exists, TruCare ProAuth lets the provider know instantly. If an authorization is required, TruCare ProAuth prepopulates fields to make data entry more efficient. Further, health plans can implement rules-based configurations to prompt providers to include specific clinical information to expedite decision making. ProAuth increases provider engagement by providing access to:
TruCare ProAuth can be seamlessly embedded into a parent portal via single sign-on which allows providers to maintain a single login for portal access. The module gives them 24x7x365 access to submit prior authorizations and receive real-time responses. Additionally, the TruCare pre-screening feature provides immediate feedback to users when:
Health plan staff members experience administrative savings by:
Electronic Authorization Submissions – allows providers to submit authorizations electronically
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Authorization Status – allows providers to view the status of submitted authorizations
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Security – uses industry standard security (Spring, OAuth)
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Pre-screener – increases provider adoption/productivity by allowing providers to exit the authorization process early when authorizations are not required
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Member and Provider Data Syncing – uses the member and provider data from TruCare without the need for duplicate data loading
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Authorization Field Mapping – authorization form configuration is accessed via the API – minimal configuration needed outside of TruCare
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Fully Integrated Module – built on TruCare APIs eliminating the need for maintaining version alignment; advances with TruCare Capabilities
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User Management – automated TruCare user syncing. Delegated access management for Provider superusers
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TruCare Hosting – TruCare portal is co-located with existing TruCare instance
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