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McKesson Expands New Auto Authorization Capability Into Care Management Workflow SoftwareSeptember 29, 2009 |
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Clear Coverage Integration with CareEnhance Clinical Management System Saves Time and Lowers Administrative Costs for Healthcare Payors and Providers McKesson today announced the integration of its CareEnhance ® Clinical Management Software ( CCMS ® ) system with Clear Coverage™ , the company’s new automated authorization solution that incorporates InterQual ® Criteria . The combined technologies support a more complete and streamlined medical management and utilization management workflow so health plans can reduce manual processes for themselves and their providers and save administrative costs. The integration of the two solutions automates a significant portion of the utilization management workflow. Authorization requests initiated by providers using the Clear Coverage solution can be automatically approved, denied or pended, and that decision is communicated immediately to the provider and simultaneously sent for appropriate UM workflow processing. Requests requiring further review automatically appear as a reminder within CCMS for the care manager. Once an authorization outcome is determined and recorded in CCMS, the outcome automatically flows back into Clear Coverage for communication to the provider. “By leveraging McKesson’s innovative technology and clinical content to automate authorization and coverage decisions in real time, we are truly helping our payor and provider clients to increase efficiency and manage costs,” said Matthew Zubiller, vice president for McKesson’s Advanced Diagnostics Management. “When care managers are relieved of the burden of faxing or making phone calls, they have more time to focus on managing patient care.” Clear Coverage is an auto authorization and coverage determination solution that enables health plans and their providers to automate medical necessity reviews to support real-time, evidence-based decisions at the point of care and within the healthcare payor organization. The solution features InterQual gold-standard clinical guidelines for the appropriateness of procedures, imaging and molecular diagnostics. Clear Coverage is among the flagship offerings of McKesson’s Advanced Diagnostics Management solutions, which connect payors, providers and diagnostic facilities to support selection, performance and reimbursement of the right diagnostics at the right time for the right cost. The CCMS suite enables healthcare payors to deliver optimal care management while optimizing their resources. The integrity of CCMS’ clinical content enables health plans to make decisions that are based on clinical evidence, align with case and disease management practices, and meet accreditation and regulatory standards. Today more than 60 organizations covering over 21 million lives use CCMS. About McKesson McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. McKesson has been in continuous operation for more than 175 years, making it the longest-operating company in healthcare today. Over the course of its history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit us at www.mckesson.com .
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McKesson Health Solutions
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